Healthcare Provider Details

I. General information

NPI: 1285695791
Provider Name (Legal Business Name): MANJUL SHARMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2006
Last Update Date: 07/20/2023
Certification Date: 07/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6740 ALEXANDER BELL DR # 300
COLUMBIA MD
21046-2248
US

IV. Provider business mailing address

6740 ALEXANDER BELL DR # 300
COLUMBIA MD
21046-2248
US

V. Phone/Fax

Practice location:
  • Phone: 410-564-0000
  • Fax: 410-564-0032
Mailing address:
  • Phone: 410-564-0000
  • Fax: 410-564-0032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberD0054257
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0054257
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: