Provider Demographics
NPI:1053312983
Name:SHARP, WILLIAM COLEMAN (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:COLEMAN
Last Name:SHARP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25925 TELEGRAPH RD
Mailing Address - Street 2:210
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48034-2518
Mailing Address - Country:US
Mailing Address - Phone:248-746-0342
Mailing Address - Fax:248-746-0308
Practice Address - Street 1:21700 NORTHWESTERN HWY
Practice Address - Street 2:600
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4906
Practice Address - Country:US
Practice Address - Phone:248-559-6664
Practice Address - Fax:248-559-5628
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301036715207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI350039810Medicaid
MI0F36477060Medicare ID - Type Unspecified
MIB46626Medicare UPIN