Healthcare Provider Details

I. General information

NPI: 1386887198
Provider Name (Legal Business Name): RUPA KUMARI SHARMA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2009
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 WILSON CREEK RD
LAWRENCEBURG IN
47025-1095
US

IV. Provider business mailing address

606 WILSON CREEK RD
LAWRENCEBURG IN
47025-1095
US

V. Phone/Fax

Practice location:
  • Phone: 812-496-8794
  • Fax: 812-537-4979
Mailing address:
  • Phone: 812-496-8794
  • Fax: 812-537-4979

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number284585
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number01091467A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35.147774
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number58513
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: