Provider Demographics
NPI:1043342439
Name:SHARMA, MAHABIR P (MD)
Entity type:Individual
Prefix:
First Name:MAHABIR
Middle Name:P
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 1:614 EASTERN SHORE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-5955
Mailing Address - Country:US
Mailing Address - Phone:410-546-1331
Mailing Address - Fax:410-543-8107
Practice Address - Street 1:614 EASTERN SHORE DR
Practice Address - Street 2:SUITE B
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-5955
Practice Address - Country:US
Practice Address - Phone:410-546-1331
Practice Address - Fax:410-543-8107
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0014087174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD813LMedicare ID - Type Unspecified
MDD74442Medicare UPIN