Basic Information
| Provider Information | |||||||||
| NPI: | 1508076514 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SHARMA | ||||||||
| FirstName: | MADDIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 371062 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152517062 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8886479600 | ||||||||
| FaxNumber: | 4126474050 | ||||||||
| Practice Location | |||||||||
| Address1: | 1604 BURTNER RD | ||||||||
| Address2: | |||||||||
| City: | NATRONA HEIGHTS | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150652845 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242303011 | ||||||||
| FaxNumber: | 7242303004 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2007 | ||||||||
| LastUpdateDate: | 04/09/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | 2007-01809 | NC | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 2085R0001X | 212350 | MA | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 2085R0001X | MD442300 | PA | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
ID Information
| ID | Type | State | Issuer | Description | 147R6 | 01 | NC | BLUE CROSS NC | OTHER | 5908218 | 05 | NC | MEDICAID | 1508076514 | 01 | NC | PARTNERS MEDICARE | OTHER |