Provider Demographics
NPI:1871811240
Name:RAVINDER K SHARMA MD PLLC
Entity type:Organization
Organization Name:RAVINDER K SHARMA MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAVINDER
Authorized Official - Middle Name:K
Authorized Official - Last Name:SHARMA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-964-1300
Mailing Address - Street 1:601 S SHORE DR
Mailing Address - Street 2:SUITE 330
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-5440
Mailing Address - Country:US
Mailing Address - Phone:269-964-1300
Mailing Address - Fax:269-964-9493
Practice Address - Street 1:601 S SHORE DR
Practice Address - Street 2:SUITE 330
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014-5440
Practice Address - Country:US
Practice Address - Phone:269-964-1300
Practice Address - Fax:269-964-9493
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-11
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010567882084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0130141OtherBLUE CROSS BLUE SHIELF
MI4475208Medicaid
MI0N50250Medicare PIN