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General NPI Number Information
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NPI Number | 1558414870
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Entity Type | Individual
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Provider Name | REVA SHARMA M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 03/20/2021
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Provider Practice Location Address
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Address Line | 7825 MCFARLAND LN SUITE B
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City | INDIANAPOLIS
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State | IN
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Zip | 46237-3628
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Country | US
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Telephone | 317-889-6551
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Fax | 317-889-6651
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Provider Business Mailing Address
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Address Line | PO BOX 781076
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City | DETROIT
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State | MI
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Zip | 48278-1076
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Country | US
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Telephone | 317-528-4800
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Fax | 317-865-1479
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01046335A
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License Number State | IN
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