Provider Demographics
NPI:1689866493
Name:SHARMA, DEEPA S (MD)
Entity type:Individual
Prefix:DR
First Name:DEEPA
Middle Name:S
Last Name:SHARMA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:DEEPA
Other - Middle Name:S
Other - Last Name:TAGGARSHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:22250 PROVIDENCE DR
Mailing Address - Street 2:SUITE 702
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4825
Mailing Address - Country:US
Mailing Address - Phone:248-557-9650
Mailing Address - Fax:248-557-5033
Practice Address - Street 1:22250 PROVIDENCE DR
Practice Address - Street 2:SUITE 702
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4825
Practice Address - Country:US
Practice Address - Phone:248-557-9650
Practice Address - Fax:248-557-5033
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301089750208C00000X, 208600000X
CAC202066208600000X, 208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery