MEDICARE: DR. VIDHU SHARMA M.D.

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	207Q00000X	Family Medicine Physician	MD423445	PA

General Provider Information

NPI Number	:	1164621090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VIDHU SHARMA M.D.

Provider Business Mailing Address
First Line	:	935 THORN RUN RD
Second Line	:	SUITE 201
City	:	MOON TWP
State	:	PA
Zip	:	15108-2861
Country	:	US
Telephone Number	:	412-749-6826
Fax Number	:	412-749-6827

Provider Business Practice Location Address
First Line	:	935 THORN RUN RD
Second Line	:	SUITE 201
City	:	MOON TWP
State	:	PA
Zip	:	15108-2861
Country	:	US
Telephone Number	:	412-749-6826
Fax Number	:	412-749-6827

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

Provider Enumeration Date	:	07/11/2007
Last Update Date	:	06/06/2024

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