Healthcare Provider Details

I. General information

NPI: 1164640470
Provider Name (Legal Business Name): SHEO P. SHARMA MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 YORK RD STE A101
LUTHERVILLE MD
21093-6240
US

IV. Provider business mailing address

1212 YORK RD STE A101
LUTHERVILLE MD
21093-6240
US

V. Phone/Fax

Practice location:
  • Phone: 443-394-0520
  • Fax: 443-394-0524
Mailing address:
  • Phone: 443-394-0520
  • Fax: 443-394-0524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD22638
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: SHEO P SHARMA
Title or Position: MEDICAL DIRECTOR/OWNER
Credential: MD
Phone: 443-394-0520