Healthcare Provider Details

I. General information

NPI: 1871704122
Provider Name (Legal Business Name): MUKESH KUMAR SHARMA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5437 KIETZKE LN
RENO NV
89511-1088
US

IV. Provider business mailing address

5437 KIETZKE LN
RENO NV
89511-1088
US

V. Phone/Fax

Practice location:
  • Phone: 775-322-4550
  • Fax: 775-322-4956
Mailing address:
  • Phone: 775-322-4550
  • Fax: 775-322-4956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number19222
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number19222
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number19222
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: