Provider Demographics
NPI:1659699189
Name:SHARMA-ROBERTS, RAVNITA (MD)
Entity Type:Individual
Prefix:
First Name:RAVNITA
Middle Name:
Last Name:SHARMA-ROBERTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RAVNITA
Other - Middle Name:
Other - Last Name:SHARMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 67000, DEPARTMENT 272801
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-0001
Mailing Address - Country:US
Mailing Address - Phone:517-205-3867
Mailing Address - Fax:517-803-2133
Practice Address - Street 1:205 N EAST AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201
Practice Address - Country:US
Practice Address - Phone:517-205-4800
Practice Address - Fax:517-205-5903
Is Sole Proprietor?:No
Enumeration Date:2010-05-07
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301095740207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology