Provider Demographics
NPI:1457954604
Name:MANOJ K. SHARMA DO PLLC
Entity type:Organization
Organization Name:MANOJ K. SHARMA DO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MANOJ
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:702-291-8511
Mailing Address - Street 1:2931 N TENAYA WAY STE 206
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-0458
Mailing Address - Country:US
Mailing Address - Phone:702-291-8511
Mailing Address - Fax:702-832-0693
Practice Address - Street 1:2931 N TENAYA WAY STE 206
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0458
Practice Address - Country:US
Practice Address - Phone:702-291-8511
Practice Address - Fax:702-832-0693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty