Provider Demographics
NPI:1407958440
Name:SHARMA, VISHNU KANT (MD)
Entity Type:Individual
Prefix:DR
First Name:VISHNU
Middle Name:KANT
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3257 DAVISON ROAD
Mailing Address - Street 2:
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-2909
Mailing Address - Country:US
Mailing Address - Phone:810-664-4713
Mailing Address - Fax:810-664-3503
Practice Address - Street 1:3257 DAVISON ROAD
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2909
Practice Address - Country:US
Practice Address - Phone:810-664-4713
Practice Address - Fax:810-664-3503
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI36505207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2100613Medicaid
04419131112Medicare ID - Type Unspecified
MI2100613Medicaid