Provider Demographics
NPI:1518954254
Name:SHARMA, RAVINDER K (MD)
Entity type:Individual
Prefix:DR
First Name:RAVINDER
Middle Name:K
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 S SHORE DR
Mailing Address - Street 2:STE 330
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-4440
Mailing Address - Country:US
Mailing Address - Phone:269-964-1300
Mailing Address - Fax:269-964-9493
Practice Address - Street 1:601 S SHORE DR
Practice Address - Street 2:STE 330
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-4440
Practice Address - Country:US
Practice Address - Phone:269-964-1300
Practice Address - Fax:269-964-9493
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL6085662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4475208Medicaid
ON50250Medicare ID - Type Unspecified
MI4475208Medicaid