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General NPI Number Information
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NPI Number | 1124251871
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Entity Type | Individual
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Provider Name | JITENDRA SHARMA M.B.B.S
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Gender | Male
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Dates
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Enumeration Date | 08/28/2009
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Last Update Date | 10/19/2017
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Provider Practice Location Address
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Address Line | 513 BROOKWOOD BLVD STE 372
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City | BIRMINGHAM
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State | AL
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Zip | 35209-7807
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Country | US
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Telephone | 205-802-6595
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Fax | 205-802-6598
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Provider Business Mailing Address
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Address Line | 513 BROOKWOOD BLVD STE 372
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City | BIRMINGHAM
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State | AL
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Zip | 35209-7807
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Country | US
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Telephone | 205-802-6595
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Fax | 205-802-6598
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | APPLIED
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | 8232
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License Number State | SD
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Taxonomy #3
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Taxonomy Code | 2084V0102X
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Taxonomy Name | Vascular Neurology Physician
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License Number | 35083
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License Number State | AL
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