Provider Demographics
NPI:1255590626
Name:SANJEEV SHARMA, MD, PC
Entity type:Organization
Organization Name:SANJEEV SHARMA, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRSCHNER
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:801-699-5392
Mailing Address - Street 1:28 WORCESTER RD
Mailing Address - Street 2:ROUTE 9
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-5308
Mailing Address - Country:US
Mailing Address - Phone:508-879-5111
Mailing Address - Fax:508-879-5115
Practice Address - Street 1:28 WORCESTER RD
Practice Address - Street 2:ROUTE 9
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-5308
Practice Address - Country:US
Practice Address - Phone:508-879-5111
Practice Address - Fax:508-879-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA20583Medicare PIN
MAG12462Medicare UPIN