Healthcare Provider Details

I. General information

NPI: 1669474326
Provider Name (Legal Business Name): PRIMECARE MEDICAL GROUP PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 03/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

622 GEORGES RD SUITE 303
NORTH BRUNSWICK NJ
08902-3377
US

IV. Provider business mailing address

622 GEORGES RD SUITE 303
NORTH BRUNSWICK NJ
08902-3377
US

V. Phone/Fax

Practice location:
  • Phone: 732-745-4994
  • Fax: 732-745-7044
Mailing address:
  • Phone: 732-745-4994
  • Fax: 732-745-7044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BHUDEV SHARMA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 732-745-4994