MEDICARE: DEEPAK SHARMA, M.D., LTD.

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	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1922287168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEEPAK SHARMA, M.D., LTD.

Provider Business Mailing Address
First Line	:	4275 BURNHAM AVE STE 128
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5400
Country	:	US
Telephone Number	:	702-853-7777
Fax Number	:	702-853-7770

Provider Business Practice Location Address
First Line	:	4275 BURNHAM AVE STE 128
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5400
Country	:	US
Telephone Number	:	702-853-7777
Fax Number	:	702-853-7770

Authorized Official
Title or Position	:	BILLING
Name	:	RENU KHITRI
Credential	:
Telephone Number	:	702-853-7777

Provider Enumeration Date	:	10/24/2007
Last Update Date	:	12/26/2007

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