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General NPI Number Information
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NPI Number | 1467464883
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Entity Type | Organization
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Legal Business Name | SOORYA K SHARMA MD PC
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 04/08/2025
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Provider Practice Location Address
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Address Line | 2660 44TH ST SW SUITE 100
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City | WYOMING
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State | MI
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Zip | 49519-4200
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Country | US
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Telephone | 616-974-9760
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Fax | 616-974-9769
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Provider Business Mailing Address
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Address Line | 1630 FLOWERS MILL DR NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49525-9694
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Country | US
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Telephone | 616-361-3613
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Fax | 616-361-3613
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SOORYA KANT SHARMA
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Credential | MD
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Telephone | 616-974-9760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301065270
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License Number State | MI
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