MEDICARE: DR. NEIL SHARMA OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	0618003141	VA

General Provider Information

NPI Number	:	1548973472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NEIL SHARMA OD

Provider Business Mailing Address
First Line	:	20251 KIAWAH ISLAND DR
Second Line	:
City	:	ASHBURN
State	:	VA
Zip	:	20147-3173
Country	:	US
Telephone Number	:	510-565-6368
Fax Number	:

Provider Business Practice Location Address
First Line	:	20251 KIAWAH ISLAND DR
Second Line	:
City	:	ASHBURN
State	:	VA
Zip	:	20147-3173
Country	:	US
Telephone Number	:	510-565-6368
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2023
Last Update Date	:	02/02/2023

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