Provider Demographics
NPI:1013977859
Name:LOHANI-SHARMA, BIDYA (MD)
Entity type:Individual
Prefix:
First Name:BIDYA
Middle Name:
Last Name:LOHANI-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 1:845 E WARNER RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-1058
Mailing Address - Country:US
Mailing Address - Phone:480-786-5000
Mailing Address - Fax:480-786-5050
Practice Address - Street 1:845 E WARNER RD STE 101
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-1058
Practice Address - Country:US
Practice Address - Phone:480-786-5000
Practice Address - Fax:480-786-5050
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2014-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30769207R00000X, 207RG0300X
IN01053662A207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ768971Medicaid
AZH84753Medicare UPIN
AZ79271Medicare ID - Type UnspecifiedMEDICARE NUMBER
AZ768971Medicaid