Individual
KUNJBALA SHARMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1145 MAIN ST, PAWTUCKET, RI 02860-4807
(401) 722-0081
(401) 312-0318
Mailing address
39 EAST AVE, BLACKSTONE VALLEY COMMUNITY HEALTH CARE, PAWTUCKET, RI 02860-4003
(401) 722-0081
(401) 312-0318
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD07897
RI
208000000X
Pediatrics Physician
39079
MA
208D00000X
General Practice Physician
39079
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
400561
BC BS OF RI (BLUECHIP)
RI
01
—
961244-01
NETWORK HEALTH
MA
05
—
9765239
—
MA
01
—
E05285
BC BS OF MA
MA
Enumeration date
12/27/2006
Last updated
07/12/2019
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