Basic Information
Provider Information
NPI: 1023543410
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PRICE
FirstName: SHARMILA
MiddleName: PEARL
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 33 W RAHN RD
Address2:  
City: DAYTON
State: OH
PostalCode: 454292219
CountryCode: US
TelephoneNumber: 9374338990
FaxNumber: 9374338691
Practice Location
Address1: 33 W RAHN RD
Address2:  
City: DAYTON
State: OH
PostalCode: 454292219
CountryCode: US
TelephoneNumber: 9374338990
FaxNumber: 9374338691
Other Information
ProviderEnumerationDate: 04/24/2017
LastUpdateDate: 07/29/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/29/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207R00000X35.139231OHY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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