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General NPI Number Information
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NPI Number | 1962511725
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Entity Type | Individual
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Provider Name | SHEELE SHARMA MD
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Gender | Female
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 330 BARCLAY AVE NE STE GL2
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2525
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Country | US
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Telephone | 616-459-4314
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Fax |
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Provider Business Mailing Address
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Address Line | 348 SHORE HAVEN DR SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-2258
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Country | US
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Telephone | 616-459-4314
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301031122
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License Number State | MI
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