Provider Demographics
NPI:1982651881
Name:SHARMAN, PUNAM (MD)
Entity Type:Individual
Prefix:DR
First Name:PUNAM
Middle Name:
Last Name:SHARMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PUNAM
Other - Middle Name:
Other - Last Name:SHARMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9001 MILLER RD
Mailing Address - Street 2:SUITE5
Mailing Address - City:SWARTZ CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:48473-1115
Mailing Address - Country:US
Mailing Address - Phone:810-630-0404
Mailing Address - Fax:810-630-2306
Practice Address - Street 1:9001 MILLER RD
Practice Address - Street 2:SUITE 5
Practice Address - City:SWARTZ CREEK
Practice Address - State:MI
Practice Address - Zip Code:48473-1115
Practice Address - Country:US
Practice Address - Phone:810-630-0404
Practice Address - Fax:810-230-2306
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301072232207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H65039Medicare UPIN