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General NPI Number Information
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NPI Number | 1720572290
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Entity Type | Individual
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Provider Name | JATIN SHARMA MD
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Gender | Male
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 3581 W 13 MILE RD
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City | ROYAL OAK
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State | MI
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Zip | 48073-6710
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Country | US
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Telephone | 248-898-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 26901 BEAUMONT BLVD STE 3D
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3849
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 328935
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301502518
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License Number State | MI
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