Provider Demographics
NPI:1720228430
Name:ARYAMA D SHARMA MD PA
Entity Type:Organization
Organization Name:ARYAMA D SHARMA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARYAMA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-382-0700
Mailing Address - Street 1:260 SW 84TH AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-2715
Mailing Address - Country:US
Mailing Address - Phone:954-382-0700
Mailing Address - Fax:954-382-0400
Practice Address - Street 1:260 SW 84TH AVE
Practice Address - Street 2:SUITE A
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2715
Practice Address - Country:US
Practice Address - Phone:954-382-0700
Practice Address - Fax:954-382-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-20
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME59072207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL053491900Medicaid
FLA12444Medicare UPIN