Provider Demographics
NPI:1558498865
Name:DIABETES AND ENDOCRINE CONSULTANTS LEVY SHARON MISRA AND YU PC
Entity type:Organization
Organization Name:DIABETES AND ENDOCRINE CONSULTANTS LEVY SHARON MISRA AND YU PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHARON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-870-4100
Mailing Address - Street 1:12070 OLD LINE CENTRE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602
Mailing Address - Country:US
Mailing Address - Phone:301-870-4100
Mailing Address - Fax:301-870-5109
Practice Address - Street 1:12070 OLD LINE CENTRE
Practice Address - Street 2:SUITE 102
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602
Practice Address - Country:US
Practice Address - Phone:301-870-4100
Practice Address - Fax:301-870-5109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC731619Medicare PIN
MDKK16Medicare PIN