Healthcare Provider Details

I. General information

NPI: 1780930495
Provider Name (Legal Business Name): VHADA SHANTI SHARMA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2012
Last Update Date: 07/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4870 YORK ROAD
BUCKINGHAM PA
18912-0665
US

IV. Provider business mailing address

PO BOX 665
BUCKINGHAM PA
18912-0665
US

V. Phone/Fax

Practice location:
  • Phone: 215-794-3305
  • Fax:
Mailing address:
  • Phone: 215-794-3305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD446372
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25MA09120500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: