=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811703341
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CV HEART & VASCULAR PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/09/2024
-----------------------------------------------------
Last Update Date | 12/09/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20 S 36TH ST STE 101
-----------------------------------------------------
City | CAMP HILL
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17011-4358
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-884-6369
-----------------------------------------------------
Fax | 717-844-6429
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 43 EASTGATE DR STE 300
-----------------------------------------------------
City | CARLISLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17015-6941
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-884-6369
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ADITYA C SHARMA
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 717-919-6618
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 207RI0011X
-----------------------------------------------------
Taxonomy Name | Interventional Cardiology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------