Provider Demographics
NPI:1760465090
Name:SHARMA, RUCHIKA P (MD)
Entity Type:Individual
Prefix:
First Name:RUCHIKA
Middle Name:P
Last Name:SHARMA
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 1:6005 PARK AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5202
Mailing Address - Country:US
Mailing Address - Phone:901-763-0833
Mailing Address - Fax:901-763-3831
Practice Address - Street 1:6005 PARK AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-5202
Practice Address - Country:US
Practice Address - Phone:901-763-0833
Practice Address - Fax:901-763-3831
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39957207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3331424Medicaid
TNI32339Medicare UPIN
TN3331424Medicaid