Provider Demographics
NPI:1144258401
Name:SHARMA, TRILOK (MD)
Entity type:Individual
Prefix:
First Name:TRILOK
Middle Name:
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 1:7255 OLD OAK BLVD
Mailing Address - Street 2:C208
Mailing Address - City:MIDDLEBURG HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3329
Mailing Address - Country:US
Mailing Address - Phone:440-816-2708
Mailing Address - Fax:440-243-8480
Practice Address - Street 1:7255 OLD OAK BLVD
Practice Address - Street 2:C208
Practice Address - City:MIDDLEBURG HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3329
Practice Address - Country:US
Practice Address - Phone:440-816-2708
Practice Address - Fax:440-243-8480
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35045750207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2500481OtherUNITED HEALTHCARE
OH0513760Medicaid
OH110054252OtherRAILROAD MEDICARE
OH341487428OtherTAX ID
OH000000132620OtherANTHEM BLUE CROSS/BLUE SH
OH100651OtherKAISER
OH53082OtherQUALCHOICE
OH4078421OtherAETNA
OH0495598Medicare ID - Type Unspecified
OHA80010Medicare UPIN
OH4103511Medicare ID - Type Unspecified
OH0495599Medicare ID - Type Unspecified
OH341487428OtherTAX ID