Healthcare Provider Details

I. General information

NPI: 1659730232
Provider Name (Legal Business Name): SARA SHARMA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2016
Last Update Date: 05/11/2022
Certification Date: 05/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10810 DARNESTOWN RD STE 101
GAITHERSBURG MD
20878
US

IV. Provider business mailing address

120 PARAMOUNT PARK DR APT 501
GAITHERSBURG MD
20879-3593
US

V. Phone/Fax

Practice location:
  • Phone: 301-762-3338
  • Fax:
Mailing address:
  • Phone: 571-255-0625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number01630
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: