MEDICARE: DR. SANJEEV 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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	35-088274	OH

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	364004	OTHER	OH	WELLCARE
3	751011	OTHER	OH	BUCKEYE
4	000000503671	OTHER	OH	ANTHEM
5	000000221392	OTHER	OH	UNISON
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	7164035	OTHER	OH	AETNA

General Provider Information

NPI Number	:	1649250895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANJEEV SHARMA MD

Provider Business Mailing Address
First Line	:	PO BOX 3158
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97208-3158
Country	:	US
Telephone Number	:	541-732-7850
Fax Number	:	541-732-7851

Provider Business Practice Location Address
First Line	:	940 ROYAL AVE
Second Line	:	SUITE 450
City	:	MEDFORD
State	:	OR
Zip	:	97504-6193
Country	:	US
Telephone Number	:	541-732-7850
Fax Number	:	541-732-7851

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

Provider Enumeration Date	:	01/21/2006
Last Update Date	:	05/10/2010

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Directions to “ DR. SANJEEV SHARMA MD” Practice Location

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