Provider Demographics
NPI:1053363291
Name:INTER MED ASSOCIATES, P.C.
Entity type:Organization
Organization Name:INTER MED ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ISHWARA
Authorized Official - Middle Name:N
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:508-949-8118
Mailing Address - Street 1:72 CUDWORTH RD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01570-3157
Mailing Address - Country:US
Mailing Address - Phone:508-949-8118
Mailing Address - Fax:508-461-0013
Practice Address - Street 1:72 CUDWORTH RD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:MA
Practice Address - Zip Code:01570-3157
Practice Address - Country:US
Practice Address - Phone:508-461-0011
Practice Address - Fax:508-949-8104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-16
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA223405207R00000X
MA70743207R00000X
MA79217207R00000X
MA36016207RC0000X
MA234882207RC0000X
MA36320207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM20910Medicare PIN