Provider Demographics
NPI:1700943404
Name:SARITA S. SHARMA, M.D., INTERNAL MEDICINE P.L.L.C.
Entity Type:Organization
Organization Name:SARITA S. SHARMA, M.D., INTERNAL MEDICINE P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARITA
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-518-4550
Mailing Address - Street 1:8595 W IRMA LN
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-1444
Mailing Address - Country:US
Mailing Address - Phone:623-518-4550
Mailing Address - Fax:623-518-2593
Practice Address - Street 1:9515 W CAMELBACK RD
Practice Address - Street 2:SUITE 116
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-1355
Practice Address - Country:US
Practice Address - Phone:623-518-4550
Practice Address - Fax:623-518-2593
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SARITA S. SHARMA,M.D. INTERNAL MEDICINE,PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-02
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ25572207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0440920OtherBCBS
AZ501868Medicaid
AZG59397Medicare UPIN