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General NPI Number Information
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NPI Number | 1750667051
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Entity Type | Individual
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Provider Name | MAMTA SHERCHAN MD
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Gender | Female
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Dates
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Enumeration Date | 10/31/2011
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Last Update Date | 11/29/2024
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Provider Practice Location Address
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Address Line | 810 SIR THOMAS CT STE 101
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City | HARRISBURG
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State | PA
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Zip | 17109-4839
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Country | US
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Telephone | 717-614-4420
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Fax | 717-614-4421
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Provider Business Mailing Address
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Address Line | 810 SIR THOMAS CT STE 101
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City | HARRISBURG
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State | PA
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Zip | 17109-4839
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Country | US
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Telephone | 717-614-4420
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Fax | 717-614-4421
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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 | MD471721
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | MD471721
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License Number State | PA
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