Provider Demographics
NPI:1861573719
Name:SHARANGPANI, ADITI (MD)
Entity type:Individual
Prefix:
First Name:ADITI
Middle Name:
Last Name:SHARANGPANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 E MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48912-1811
Mailing Address - Country:US
Mailing Address - Phone:517-364-2117
Mailing Address - Fax:517-364-3994
Practice Address - Street 1:1215 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-1811
Practice Address - Country:US
Practice Address - Phone:517-364-2117
Practice Address - Fax:517-364-3994
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010747062080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD774251700Medicaid
MI1861573719Medicaid
VA010195683Medicaid
DC027923400Medicaid
018630C95Medicare ID - Type Unspecified
MD774251700Medicaid
MIMI4401003Medicare PIN