Provider Demographics
NPI:1801859939
Name:SHAROFF, SURESH R (MD)
Entity Type:Individual
Prefix:DR
First Name:SURESH
Middle Name:R
Last Name:SHAROFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9800 SHELBYVILLE RD STE 220
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2992
Mailing Address - Country:US
Mailing Address - Phone:502-429-8585
Mailing Address - Fax:855-656-7325
Practice Address - Street 1:7287 SAWMILL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9021
Practice Address - Country:US
Practice Address - Phone:614-760-0099
Practice Address - Fax:855-656-7325
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35051349S207KA0200X
OH35.051349207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0217385Medicaid
OHC35239Medicare UPIN
OHSU0796399Medicare ID - Type Unspecified