Provider Demographics
NPI:1912972597
Name:SHARMA, RAM CHARITRA (MD)
Entity Type:Individual
Prefix:DR
First Name:RAM
Middle Name:CHARITRA
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GUTHRIE SQ
Mailing Address - Street 2:
Mailing Address - City:SAYRE
Mailing Address - State:PA
Mailing Address - Zip Code:18840-1625
Mailing Address - Country:US
Mailing Address - Phone:570-888-5858
Mailing Address - Fax:
Practice Address - Street 1:1 GUTHRIE SQ
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840-1625
Practice Address - Country:US
Practice Address - Phone:570-888-5858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224303-1207R00000X
PAMD053496L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0016813470001Medicaid
NY01805632Medicaid
PA110209244OtherRR MEDICARE PIN
PACC9269OtherRR MEDICARE GROUP
NYP00313959OtherRR MEDICARE PIN
PAGU039812OtherPA MEDICARE GROUP
NYCC8362OtherRR MEDICARE GROUP
G63063Medicare UPIN
PAGU039812OtherPA MEDICARE GROUP
PA0016813470001Medicaid