Provider Demographics
NPI:1770564379
Name:SHARMA, BALBIR CHAND (MD)
Entity type:Individual
Prefix:DR
First Name:BALBIR
Middle Name:CHAND
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:17322 N 77TH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-5827
Mailing Address - Country:US
Mailing Address - Phone:480-894-1071
Mailing Address - Fax:480-894-1435
Practice Address - Street 1:1730 S JENTILLY LN
Practice Address - Street 2:B-102
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85281-5715
Practice Address - Country:US
Practice Address - Phone:480-894-1071
Practice Address - Fax:480-894-1435
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-10
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ144992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD4490Medicare UPIN
AZMD14499Medicare ID - Type UnspecifiedMEDICARE