Healthcare Provider Details

I. General information

NPI: 1770797359
Provider Name (Legal Business Name): RAJIV KUMAR SHARMA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 07/01/2025
Certification Date: 06/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 COLUMBUS AVE BAY REGION
BAY CITY MI
48708-6831
US

IV. Provider business mailing address

1155 S CONGRESS AVE STE C
WEST PALM BEACH FL
33406-5114
US

V. Phone/Fax

Practice location:
  • Phone: 989-894-3000
  • Fax:
Mailing address:
  • Phone: 561-766-1300
  • Fax: 561-257-3477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number01072350A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number13554
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME147718
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: