Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | 56017 | WI |
Y | 207RH0002X | Hospice and Palliative Medicine | 56017 | WI |
NPI | 1033210968 |
---|---|
Provider Name | Dr. Kavita Sharma |
First Address | Milwaukee, WI 53215-2843 |
Second Address | Wauwatosa, WI 53213 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2006 |
Last Update Date | 22/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000228726 | HMSA BILLING NUMBER (01) | HI |
497174-01 | (05) | HI |
H35015 | (02) | HI |