MEDICARE: SATISH SHARMA SINGLE MBR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208VP0000X	Pain Medicine Physician

General Provider Information

NPI Number	:	1033389812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SATISH SHARMA SINGLE MBR

Provider Business Mailing Address
First Line	:	5375 S FORT APACHE RD
Second Line	:	SUITE 102
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-7623
Country	:	US
Telephone Number	:	702-739-8323
Fax Number	:	702-739-8605

Provider Business Practice Location Address
First Line	:	5375 S FORT APACHE RD
Second Line	:	SUITE 102
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-7623
Country	:	US
Telephone Number	:	702-739-8323
Fax Number	:	702-739-8605

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SATISH K SHARMA
Credential	:	MD
Telephone Number	:	702-739-8323

Provider Enumeration Date	:	03/07/2008
Last Update Date	:	03/07/2008

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