Basic Information
| Provider Information | |||||||||
| NPI: | 1689815680 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHARMA | ||||||||
| FirstName: | KIRTI | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 785 5TH AVE | ||||||||
| Address2: | SUITE 3 | ||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172014232 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172639555 | ||||||||
| FaxNumber: | 7172174217 | ||||||||
| Practice Location | |||||||||
| Address1: | 112 N 7TH ST | ||||||||
| Address2: | |||||||||
| City: | CHAMBERSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 172011720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7172174300 | ||||||||
| FaxNumber: | 7172174399 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2009 | ||||||||
| LastUpdateDate: | 05/06/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | MD438614 | PA | Y | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | MD438614 | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2132658 | 01 | PA | HIGHMARK BLUESHIELD | OTHER | 25-1716306 | 01 | PA | HEALTHNET/TRICARE | OTHER | 6093373 | 01 | PA | AETNA HMO | OTHER | FS1713254 | 01 | PA | DEA | OTHER | G920-0135/KDM4CU | 01 | PA | CAREFIRST | OTHER | 102387870 0001 | 05 | PA | MEDICAID | 25-1716306 | 01 | PA | INFORMED | OTHER | PEARL PROVIDER | 01 | PA | HEALTH AMERICA | OTHER | 50044999 | 01 | PA | CAPITAL BLUECROSS | OTHER | 867633 | 01 | PA | MEDICARE GROUP # | OTHER | GROUP #2183091 | 01 | PA | MAMSI | OTHER | MD438614 | 01 | PA | LICENSE | OTHER | P00795879 | 01 | PA | RAILROAD MEDICARE | OTHER | 1007307260034 | 01 | PA | MEDICAID GROUP # | OTHER | 25-1716306 | 01 | PA | MULTIPLAN/PHCS | OTHER | 289342 | 01 | PA | UNISON | OTHER | 9839406 | 01 | PA | AETNA NON-HMO | OTHER | 25-1716306 | 01 | PA | FIRST HEALTH | OTHER | 120420410 | 01 | PA | DEPT OF LABOR | OTHER | 1585294 | 01 | PA | GATEWAY | OTHER | 25-1716306 | 01 | PA | SOUTH CENTRAL PREFERRED | OTHER | 25-1716306 | 01 | PA | DEVON | OTHER | 25-1716306 | 01 | PA | INTERGROUP | OTHER |