Healthcare Provider Details

I. General information

NPI: 1194725440
Provider Name (Legal Business Name): AMAR J SHARMA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2005
Last Update Date: 11/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 N. NEW STREET
BETHLEHEM PA
18018
US

IV. Provider business mailing address

940 N. NEW STREET
BETHLEHEM PA
18018
US

V. Phone/Fax

Practice location:
  • Phone: 610-691-1133
  • Fax: 610-691-0581
Mailing address:
  • Phone: 610-691-1133
  • Fax: 610-691-0581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD024126E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: