Basic Information
| Provider Information | |||||||||
| NPI: | 1932420957 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHARMA | ||||||||
| FirstName: | ANUJ | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4600 MEMORIAL DR STE 320 | ||||||||
| Address2: | |||||||||
| City: | BELLEVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 622265363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6182572100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4600 MEMORIAL DR STE 320 | ||||||||
| Address2: | |||||||||
| City: | BELLEVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 622265363 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6182572100 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2010 | ||||||||
| LastUpdateDate: | 07/05/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | TRN15220 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0100X | ME135462 | FL | N | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | 207RG0100X | 036159689 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology |
No ID Information.