Provider Demographics
NPI:1730165085
Name:SHARMA, RAJINDER P (MD)
Entity type:Individual
Prefix:DR
First Name:RAJINDER
Middle Name:P
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 1:24604 MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-1742
Mailing Address - Country:US
Mailing Address - Phone:313-562-9020
Mailing Address - Fax:313-562-8511
Practice Address - Street 1:24604 MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-1742
Practice Address - Country:US
Practice Address - Phone:313-562-9020
Practice Address - Fax:313-562-8511
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-19
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301060109207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4226436Medicaid
MI4226436Medicaid
0P36680Medicare PIN