Provider Demographics
NPI:1669402400
Name:MATHUR, SHARAD CHANDRA (MD)
Entity type:Individual
Prefix:
First Name:SHARAD
Middle Name:CHANDRA
Last Name:MATHUR
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:4801 LINWOOD BOULEVARD
Mailing Address - Street 2:PATHOLOGY AND LABORATORY MEDICINE SERVICE, VA MED CTR
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64128
Mailing Address - Country:US
Mailing Address - Phone:816-861-4700
Mailing Address - Fax:816-922-4633
Practice Address - Street 1:4801 LINWOOD BOULEVARD
Practice Address - Street 2:PATHOLOGY AND LABORATORY MEDICINE SERVICE, VA MED CTR
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64128
Practice Address - Country:US
Practice Address - Phone:816-861-4700
Practice Address - Fax:816-922-4633
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-04
Last Update Date:2015-09-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04-30948207ZP0102X, 207ZH0000X
MO2006006809207ZP0102X, 207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology