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Individual

DR. KAILASH B SHARMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1350 WALTON WAY, AUGUSTA, GA 30901-2612
(706) 774-5400
(706) 774-5096
Mailing address
14275 MIDWAY RD, SUITE 400, ADDISON, TX 75001-3614
(317) 275-8000
(610) 271-4245

Taxonomy

Speciality
Code
Description
License number
State
207ZM0300X
Medical Microbiology Physician
015039
GA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
015039
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000259003A
GA
01
10058418
AMERIGROUP
GA
01
285011
BCBS
GA
01
339161
WELLCARE
GA
01
581446543
TRICARE
GA
Enumeration date
01/14/2006
Last updated
07/06/2015
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