MEDICARE: FREMANTLE REGAL CORPORATION

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	12368	NV

General Provider Information

NPI Number	:	1740542331
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FREMANTLE REGAL CORPORATION

Provider Business Mailing Address
First Line	:	10620 SOUTHERN HIGHLANDS PKWY
Second Line	:	SUITE 110 #477
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-4371
Country	:	US
Telephone Number	:	702-750-1744
Fax Number	:

Provider Business Practice Location Address
First Line	:	6787 W TROPICANA AVE
Second Line	:	SUITE 110
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-4757
Country	:	US
Telephone Number	:	702-750-1744
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. BIKAS SHARMA
Credential	:	MD
Telephone Number	:	702-688-3490

Provider Enumeration Date	:	06/11/2012
Last Update Date	:	06/25/2012

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Directions to “FREMANTLE REGAL CORPORATION ” Practice Location

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