Healthcare Provider Details

I. General information

NPI: 1831763820
Provider Name (Legal Business Name): MANJARI SHARMA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2021
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3603 BIENVILLE BLVD STE 103
OCEAN SPRINGS MS
39564-5736
US

IV. Provider business mailing address

2101 HIGHWAY 90
GAUTIER MS
39553-5340
US

V. Phone/Fax

Practice location:
  • Phone: 228-762-3000
  • Fax: 228-818-4151
Mailing address:
  • Phone: 228-497-7576
  • Fax: 228-497-8869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number343384
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: