Provider Demographics
NPI:1942614466
Name:SHARMA, DIVYA
Entity Type:Individual
Prefix:DR
First Name:DIVYA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2124 CORNELL ROAD, DOA38A
Mailing Address - Street 2:CASE WESTERN RESERVE UNIVERSITY, SCHOOL OF DENTAL MEDIC
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44106-4905
Mailing Address - Country:US
Mailing Address - Phone:216-368-3236
Mailing Address - Fax:216-368-3204
Practice Address - Street 1:2124 CORNELL ROAD, DOA38A
Practice Address - Street 2:CASE WESTERN RESERVE UNIVERSITY, SCHOOL OF DENTAL MEDIC
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-4905
Practice Address - Country:US
Practice Address - Phone:216-368-3236
Practice Address - Fax:216-368-3204
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2014-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program