MEDICARE: SUNIL SHARMA MD

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	207RH0003X	Hematology & Oncology Physician	11224	NV

General Provider Information

NPI Number	:	1699775767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUNIL SHARMA MD

Provider Business Mailing Address
First Line	:	2000 CIRCLE OF HOPE DR
Second Line	:	#3380
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84112-5550
Country	:	US
Telephone Number	:	801-585-0303
Fax Number	:	801-585-0101

Provider Business Practice Location Address
First Line	:	2000 CIRCLE OF HOPE DR
Second Line	:	#3380
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84112-5550
Country	:	US
Telephone Number	:	801-585-0303
Fax Number	:	801-585-0101

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	06/22/2009

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