Provider Demographics
NPI:1710078928
Name:SENGUPTA, SHARI LEANN (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARI
Middle Name:LEANN
Last Name:SENGUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2904 GOODMAN CT
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27282-8650
Mailing Address - Country:US
Mailing Address - Phone:336-740-5393
Mailing Address - Fax:
Practice Address - Street 1:2904 GOODMAN CT
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NC
Practice Address - Zip Code:27282-8650
Practice Address - Country:US
Practice Address - Phone:336-740-5393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2003005262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
1368POtherBS/BS ID. NUMBER
NC89137WFMedicaid
NCFS0779972OtherDEA NUMBER
NCFS0779972OtherDEA NUMBER
NC89137WFMedicaid
NCH92821Medicare UPIN