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General NPI Number Information
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NPI Number | 1366337222
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Entity Type | Organization
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Legal Business Name | EASTLAND WOMENS CLINIC
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Dates
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Enumeration Date | 06/11/2025
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 15921 E. 8 MILE RD
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City | EASTPOINTE
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State | MI
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Zip | 48021
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Country | US
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Telephone | 586-774-4190
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Fax |
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Provider Business Mailing Address
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Address Line | 15921 E. 8 MILE RD
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City | EASTPOINTE
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State | MI
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Zip | 48021
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Country | US
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Telephone | 586-774-4190
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Fax |
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | REGINALD DENNIS SHARPE
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Credential | D.O.
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Telephone | 586-774-4190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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