Provider Demographics
NPI:1396779690
Name:SHARMA, SANGITA A (MD)
Entity type:Individual
Prefix:
First Name:SANGITA
Middle Name:A
Last Name:SHARMA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 TREE LN STE 160
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6765
Mailing Address - Country:US
Mailing Address - Phone:678-578-8422
Mailing Address - Fax:678-578-8423
Practice Address - Street 1:1700 TREE LN STE 160
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6765
Practice Address - Country:US
Practice Address - Phone:678-578-8422
Practice Address - Fax:678-578-8423
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA055886207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA162441900BMedicaid
H41571Medicare UPIN