Healthcare Provider Details

I. General information

NPI: 1508900549
Provider Name (Legal Business Name): ROHIT SHARMA OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 07/06/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3071 CAMPBELLTON RD SW SUITE #1
ATLANTA GA
30311-5441
US

IV. Provider business mailing address

3071 CAMPBELLTON RD SW SUITE #1
ATLANTA GA
30311-5441
US

V. Phone/Fax

Practice location:
  • Phone: 404-344-3556
  • Fax: 404-344-3500
Mailing address:
  • Phone: 404-344-3556
  • Fax: 404-344-3500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOPT002164
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: