Basic Information
| Provider Information | |||||||||
| NPI: | 1568790848 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHARMA | ||||||||
| FirstName: | SIDHARTH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2612 HOLCOMB BRIDGE RD | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | ALPHARETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300225494 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7706508980 | ||||||||
| FaxNumber: | 7706505589 | ||||||||
| Practice Location | |||||||||
| Address1: | 980 BIRMINGHAM RD STE 304 | ||||||||
| Address2: | |||||||||
| City: | MILTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300044418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4706396340 | ||||||||
| FaxNumber: | 4042508096 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/25/2009 | ||||||||
| LastUpdateDate: | 04/26/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 064967 | GA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.