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1649652470

NPI Code Detail

MEDICARE: DR. PRANAV SHARMA MD

MEDICARE: DR. PRANAV 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	2085R0204X	Vascular & Interventional Radiology Physician	036157435	IL
2	390200000X	Student in an Organized Health Care Education/Training Program
3	2085R0204X	Vascular & Interventional Radiology Physician	82525	CT

General Provider Information

NPI Number	:	1649652470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PRANAV SHARMA MD

Provider Business Mailing Address
First Line	:	PO BOX 19248
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62794-9248
Country	:	US
Telephone Number	:	217-528-7541
Fax Number	:

Provider Business Practice Location Address
First Line	:	1025 S 6TH ST
Second Line	:
City	:	SPRINGFIELD
State	:	IL
Zip	:	62703-2499
Country	:	US
Telephone Number	:	217-528-7541
Fax Number	:

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

Provider Enumeration Date	:	06/29/2015
Last Update Date	:	03/06/2026

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Directions to “ DR. PRANAV SHARMA MD” Practice Location

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