Provider Demographics
NPI:1225330533
Name:SUMBET, SHEETAL MADHURI
Entity Type:Individual
Prefix:
First Name:SHEETAL
Middle Name:MADHURI
Last Name:SUMBET
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2453 SOMERSET BLVD
Mailing Address - Street 2:APT 101
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4062
Mailing Address - Country:US
Mailing Address - Phone:248-540-8981
Mailing Address - Fax:
Practice Address - Street 1:30600 TELEGRAPH RD
Practice Address - Street 2:SUITE 2226
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4530
Practice Address - Country:US
Practice Address - Phone:248-540-5748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010452225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist