Provider Demographics
NPI:1942528575
Name:SHOME, ARUP KUMAR
Entity Type:Individual
Prefix:
First Name:ARUP
Middle Name:KUMAR
Last Name:SHOME
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 WINDY KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MI
Mailing Address - Zip Code:48306-1949
Mailing Address - Country:US
Mailing Address - Phone:248-841-1671
Mailing Address - Fax:
Practice Address - Street 1:3089 E WALTON BLVD
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-2370
Practice Address - Country:US
Practice Address - Phone:248-309-3333
Practice Address - Fax:248-309-3338
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302034650183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist