Healthcare Provider Details

I. General information

NPI: 1063463131
Provider Name (Legal Business Name): SHARMILA MAKHIJA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 11/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

529 S. JACKSON STREET 3RD FLOOR JAMES GRAHAM BROWN CANCER CENTER
LOUISVILLE KY
40202
US

IV. Provider business mailing address

550 S JACKSON ST ACB/2ND FLOOR
LOUISVILLE KY
40202-1622
US

V. Phone/Fax

Practice location:
  • Phone: 502-561-7220
  • Fax: 502-561-7327
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number24337
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License Number29816
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: