Provider Demographics
NPI:1427068097
Name:KAUL, SHARDA (MD)
Entity type:Individual
Prefix:DR
First Name:SHARDA
Middle Name:
Last Name:KAUL
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 1:421 MERRIMACK ST
Mailing Address - Street 2:SUITE 101 A
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-5864
Mailing Address - Country:US
Mailing Address - Phone:978-685-7111
Mailing Address - Fax:978-685-7133
Practice Address - Street 1:421 MERRIMACK ST
Practice Address - Street 2:SUITE 101 A
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-5864
Practice Address - Country:US
Practice Address - Phone:978-685-7111
Practice Address - Fax:978-685-7133
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA151784207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9764551Medicaid
MA9764551Medicaid
MAA22052Medicare ID - Type Unspecified