MEDICARE: SANJEEV S SHARMA MD

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	2085R0001X	Radiation Oncology Physician	19077	WV
2	2085R0001X	Radiation Oncology Physician	30682	KY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	900002277	OTHER	WV	RR MEDICARE (WV)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000000200071	OTHER	OH	UNISON
4	001718779	OTHER		MTN STATE BC BS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	550493376 00	OTHER	WV	WORKMANS COMP
8	50007263	OTHER	KY	PASSPORT
9	5123739	OTHER		AETNA

General Provider Information

NPI Number	:	1164409884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANJEEV S SHARMA MD

Provider Business Mailing Address
First Line	:	PO BOX 1104
Second Line	:
City	:	RAHWAY
State	:	NJ
Zip	:	07065-1104
Country	:	US
Telephone Number	:	973-444-2664
Fax Number	:	973-322-4132

Provider Business Practice Location Address
First Line	:	2900 1ST AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25702-1241
Country	:	US
Telephone Number	:	304-526-1143
Fax Number	:	304-526-8945

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	07/24/2011

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Directions to “ SANJEEV S SHARMA MD” Practice Location

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