Healthcare Provider Details

I. General information

NPI: 1407137441
Provider Name (Legal Business Name): VARUN SHARMA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2011
Last Update Date: 09/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 CIVIC CENTER BLVD DIVISION OF CHILD AND ADOLESCENT PSYCHIATRY
PHILADELPHIA PA
19104-4319
US

IV. Provider business mailing address

725 HORSEPOND RD
DOVER DE
19901-7232
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-7131
  • Fax: 215-590-4251
Mailing address:
  • Phone: 302-747-1100
  • Fax: 302-747-1167

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC1-0011600
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberC1-0011600
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: