Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207YS0123X | Facial Plastic Surgeon | 025413 | LA |
Y | 207YS0123X | Facial Plastic Surgeon | ME96274 | FL |
NPI | 1356595268 |
---|---|
Provider Name | Dr. Vijay M Sharma |
First Address | Jupiter, FL 33458-2788 |
Second Address | Jupiter, FL 33458-2788 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/11/2008 |
Last Update Date | 07/05/2018 |