MEDICARE: DR. SHARADA M PAI 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	2080N0001X	Neonatal-Perinatal Medicine Physician	104078	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	APS838203	OTHER	SC	CONTROLLED SUBSTANCES

General Provider Information

NPI Number	:	1285696971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHARADA M PAI MD

Provider Business Mailing Address
First Line	:	209 TIMBER RIDGE DR
Second Line	:
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29169-5411
Country	:	US
Telephone Number	:	803-794-5307
Fax Number	:

Provider Business Practice Location Address
First Line	:	209 TIMBER RIDGE DR
Second Line	:
City	:	WEST COLUMBIA
State	:	SC
Zip	:	29169-5411
Country	:	US
Telephone Number	:	803-794-5307
Fax Number	:

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

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	07/08/2007

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