MEDICARE: MADHO K SHARMA M.D P.A

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	207RP1001X	Pulmonary Disease Physician	MA030532	NJ

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	15242	OTHER	NJ	AGP
3	LS418	OTHER	NJ	OXFORD

General Provider Information

NPI Number	:	1366488306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MADHO K SHARMA M.D P.A

Provider Business Mailing Address
First Line	:	30 HOY AVE
Second Line	:
City	:	FORDS
State	:	NJ
Zip	:	08863-1920
Country	:	US
Telephone Number	:	732-225-9115
Fax Number	:	732-225-2814

Provider Business Practice Location Address
First Line	:	30 HOY AVE
Second Line	:
City	:	FORDS
State	:	NJ
Zip	:	08863-1920
Country	:	US
Telephone Number	:	732-225-9115
Fax Number	:	732-225-2814

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MADHO K SHARMA
Credential	:	M.D
Telephone Number	:	732-225-9115

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	05/23/2008

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