Provider Demographics
NPI:1710487467
Name:SHARMA, UPMA
Entity Type:Individual
Prefix:
First Name:UPMA
Middle Name:
Last Name:SHARMA
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 1:9870 TELEGRAPH RD STE B
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-3334
Mailing Address - Country:US
Mailing Address - Phone:313-295-5020
Mailing Address - Fax:313-291-0960
Practice Address - Street 1:9870 TELEGRAPH RD STE B
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-3334
Practice Address - Country:US
Practice Address - Phone:313-295-5020
Practice Address - Fax:313-291-0960
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501005979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist