Provider Demographics
NPI:1649625708
Name:SHARON, RICHARD (DO)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:
Last Name:SHARON
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3955 PATIENT CARE DR STE A
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-4271
Mailing Address - Country:US
Mailing Address - Phone:517-374-7600
Mailing Address - Fax:885-480-9150
Practice Address - Street 1:3955 PATIENT CARE DR STE A
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4271
Practice Address - Country:US
Practice Address - Phone:517-374-7600
Practice Address - Fax:885-480-9150
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-26
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI5101022452207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty