Healthcare Provider Details

I. General information

NPI: 1114131778
Provider Name (Legal Business Name): JOHN A SHARMA MD, MSC, MBA, FAAFP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 11/16/2025
Certification Date: 11/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 PRO DR STE D1
CELINA OH
45822-3307
US

IV. Provider business mailing address

200 SAINT CLAIR AVE
SAINT MARYS OH
45885-2400
US

V. Phone/Fax

Practice location:
  • Phone: 419-586-6489
  • Fax: 419-586-8509
Mailing address:
  • Phone: 419-394-3387
  • Fax: 419-394-9575

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.141306
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301088287
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: