Healthcare Provider Details

I. General information

NPI: 1497250070
Provider Name (Legal Business Name): PRERNA SHARMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2018
Last Update Date: 03/04/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4923 OGLETOWN STANTON RD STE 200
NEWARK DE
19713-2081
US

IV. Provider business mailing address

4923 OGLETOWN STANTON RD STE 200
NEWARK DE
19713-2081
US

V. Phone/Fax

Practice location:
  • Phone: 302-225-0451
  • Fax: 302-225-0472
Mailing address:
  • Phone: 302-225-0451
  • Fax: 302-225-0472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberC1-0027137
License Number StateDE
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: