1801878343 NPI number — DR. RAJESH K SHARMA MD

Table of content: DR. RAJESH K SHARMA MD (NPI 1801878343)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801878343 NPI number — DR. RAJESH K SHARMA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHARMA
Provider First Name:
RAJESH
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801878343
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
120 MEADOWCREST ST
Provider Second Line Business Mailing Address:
SUITE 245
Provider Business Mailing Address City Name:
GRETNA
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70056-5255
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-391-7690
Provider Business Mailing Address Fax Number:
504-391-7625

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 MEADOWCREST ST
Provider Second Line Business Practice Location Address:
SUITE 245
Provider Business Practice Location Address City Name:
GRETNA
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70056-5255
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-391-7690
Provider Business Practice Location Address Fax Number:
504-391-7625
Provider Enumeration Date:
11/18/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  MD.10344R , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2080N0001X , with the licence number: MD10344R , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1676489 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1290028 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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