Provider Demographics
NPI:1902808835
Name:SHARMA, SARITA (MD)
Entity Type:Individual
Prefix:
First Name:SARITA
Middle Name:
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 WYMAN PARK DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2803
Mailing Address - Country:US
Mailing Address - Phone:410-338-3500
Mailing Address - Fax:
Practice Address - Street 1:12916 CONAMAR DR
Practice Address - Street 2:SUITE 204
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21742-2760
Practice Address - Country:US
Practice Address - Phone:301-685-3166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2011-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT043218207QG0300X
MDD0070877207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT010043218CT01OtherANTHEM BC/BS
CT061561581OtherHEALTH CT
CT1061762OtherAETNA
CT001432187Medicaid
CT061561581OtherUNITED HEALTHCARE
CT043218OtherCONNECTICARE
CT2V7005OtherHEALTH NET
CT061561581OtherCIGNA
CT368744OtherWELLCARE OF CT
MDD0070877OtherMARYLAND MEDICAL BOARD PHYSICIANS LICENSE
CTP3650512OtherOXFORD
CT061561581OtherUNITED HEALTHCARE
110009540Medicare ID - Type Unspecified