Provider Demographics
NPI:1740211630
Name:SHARMA, MANEESH C (MD)
Entity Type:Individual
Prefix:
First Name:MANEESH
Middle Name:C
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 LIGHTHOUSE PT E
Mailing Address - Street 2:SUITE 402
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4777
Mailing Address - Country:US
Mailing Address - Phone:443-599-4000
Mailing Address - Fax:443-599-4012
Practice Address - Street 1:2700 LIGHTHOUSE PT E
Practice Address - Street 2:SUITE 402
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4777
Practice Address - Country:US
Practice Address - Phone:443-599-4000
Practice Address - Fax:443-599-4012
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD59785207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD402057000Medicaid
MDKR79K123Medicare PIN
MD402057000Medicaid