Provider Demographics
NPI:1548346257
Name:SHARMA, ANIL KUMAR (MD)
Entity type:Individual
Prefix:
First Name:ANIL
Middle Name:KUMAR
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:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:505-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:234 E GRAY ST
Practice Address - Street 2:STE 550
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1900
Practice Address - Country:US
Practice Address - Phone:502-629-2935
Practice Address - Fax:502-629-2932
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY32190207RC0000X, 207RI0011X
IN01062843A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1221118OtherCHA PRIME HEALTH PLAN
KY7100122420Medicaid
KY000000867302OtherANTHEM- CTS
KY50007174OtherPASSPORT HEALTH PLAN
KYP00231770OtherRAILROAD MEDICARE
KY000000364029OtherANTHEM BCBS FACET #
KY159684OtherSIHO-CTS
IN200245900Medicaid
KY299856OtherFEDERAL BLACK LUNG PROGRA
KY065550OtherSIHO HEALTH PLAN
IN20245900Medicaid
KY2448346000OtherPASSPORT ADVANTAGE PLAN
KY50065352OtherPASSPORT-CTS
KY5939876OtherCIGNA
KY7639702OtherAETNA
KY64317332Medicaid
IN20245900Medicaid
KY50007174OtherPASSPORT HEALTH PLAN
KY1221118OtherCHA PRIME HEALTH PLAN
KY2448346000OtherPASSPORT ADVANTAGE PLAN
KYK126910Medicare PIN
KY0875307Medicare ID - Type UnspecifiedTOMPKINSVILLE