Provider Demographics
NPI:1457650566
Name:SHARMA, SUNITA (MD, PH D)
Entity Type:Individual
Prefix:
First Name:SUNITA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD, PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-316-3131
Mailing Address - Fax:704-316-3132
Practice Address - Street 1:1401 MATTHEWS TOWNSHIP PKWY STE 110
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5403
Practice Address - Country:US
Practice Address - Phone:704-316-3131
Practice Address - Fax:704-316-3132
Is Sole Proprietor?:No
Enumeration Date:2011-03-15
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN56722207R00000X
MN106778207R00000X
ND15238207RC0000X
NC2022-01341207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN110016114Medicare PIN