Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301103058 | MI |
N | 111NI0900X | Internist | 4301103058 | MI |
Y | 207RC0200X | Critical Care Medicine | 2017040028 | MO |
NPI | 1043650799 |
---|---|
Provider Name | Dr. Vikas Sharma |
First Address | Springfield, MO 65804-2203 |
Second Address | Springfield, MO 65804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2013 |
Last Update Date | 23/09/2020 |