Healthcare Provider Details

I. General information

NPI: 1255745121
Provider Name (Legal Business Name): NEEL K SHARMA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2014
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 HAYES AVE
SANDUSKY OH
44870-3323
US

IV. Provider business mailing address

1912 HAYES AVE STE 1
SANDUSKY OH
44870-4736
US

V. Phone/Fax

Practice location:
  • Phone: 419-557-7400
  • Fax: 419-625-8436
Mailing address:
  • Phone: 419-557-5541
  • Fax: 419-557-5542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number35145404
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0101279765
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: