Provider Demographics
NPI:1932273901
Name:SHARMA, BHUPESH (MD)
Entity Type:Individual
Prefix:
First Name:BHUPESH
Middle Name:
Last Name:SHARMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3120 CARPENTER ST
Mailing Address - Street 2:STE 301
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-9802
Mailing Address - Country:US
Mailing Address - Phone:313-369-1600
Mailing Address - Fax:313-369-1100
Practice Address - Street 1:88 REGENTS DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-5419
Practice Address - Country:US
Practice Address - Phone:248-269-6775
Practice Address - Fax:248-269-6775
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301071743207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI104437495Medicaid
MI1106305501OtherBCBSM
MI1106305501OtherBCBSM
MIG87197Medicare UPIN