Individual
MR. PARDEEP K SHARMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
221 N OAK AVE, COOKEVILLE, TN 38501-2437
(931) 646-0880
(931) 646-0884
Mailing address
221 N OAK AVE, COOKEVILLE, TN 38501-2437
(931) 646-0880
(931) 646-0884
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
200400596
NC
207Q00000X
Family Medicine Physician
40259
TN
207Q00000X
Family Medicine Physician
Primary
MD40259
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1375M
BCBS NC
NC
05
—
1515522
—
TN
05
—
891375M
—
NC
01
—
P00191686
RAILROAD MEDICARE
NC
Enumeration date
11/10/2005
Last updated
03/15/2013
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