Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 54276 | GA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 54276 | GA |
NPI | 1013903293 |
---|---|
Provider Name | Niraj Sharma |
First Address | Lawrenceville, GA 30046-3335 |
Second Address | Lawrenceville, GA 30046-3335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2005 |
Last Update Date | 25/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
990586447A | (05) | GA |
G57451 | (02) |