Basic Information
Provider Information
NPI: 1376557140
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHARMA
FirstName: SURIT
MiddleName: KUMAR
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5200 DTC PKWY
Address2: SUITE 400
City: GREENWOOD VILLAGE
State: CO
PostalCode: 801112719
CountryCode: US
TelephoneNumber: 3037450000
FaxNumber: 3037081834
Practice Location
Address1: 5200 DTC PKWY
Address2: SUITE 400
City: GREENWOOD VILLAGE
State: CO
PostalCode: 801112719
CountryCode: US
TelephoneNumber: 3037450000
FaxNumber: 3037081834
Other Information
ProviderEnumerationDate: 07/28/2006
LastUpdateDate: 06/22/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0200X35471CON Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207RS0012X35471CON Allopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
207RP1001X35471COY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

ID Information
IDTypeStateIssuerDescription
6738658005CO MEDICAID


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