Provider Demographics
NPI:1902849532
Name:SHARMA, RAMESH MYSORE (MD)
Entity Type:Individual
Prefix:DR
First Name:RAMESH
Middle Name:MYSORE
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 1:7800 PROVIDENCE RD STE 209
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28226-2986
Mailing Address - Country:US
Mailing Address - Phone:704-544-7535
Mailing Address - Fax:704-544-7570
Practice Address - Street 1:7800 PROVIDENCE RD STE 209
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-2986
Practice Address - Country:US
Practice Address - Phone:704-544-7535
Practice Address - Fax:704-544-7570
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2007-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC95016602086S0129X
SC182322086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8976713Medicaid
SC182328Medicaid
NC76713OtherBCBS NC
NCA08606Medicare UPIN
NC2233349AMedicare PIN
NC8976713Medicaid