| Soorya K. Sharma,mdpc | |
|
2660 44th St Sw Suite 100 Wyoming MI 49519-4200 | |
| (616) 974-9760 | |
| (616) 974-9769 |
| Full Name | Soorya K. Sharma,mdpc |
|---|---|
| Speciality | Family Medicine |
| Location | 2660 44th St Sw, Wyoming, Michigan |
| Authorized Official Name and Position | Soorya Kant Sharma (PRESIDENT) |
| Authorized Official Contact | 6169749760 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Soorya K. Sharma,mdpc 1630 Flowers Mill Dr Ne Grand Rapids MI 49525-9694 Ph: (616) 361-3613 | Soorya K. Sharma,mdpc 2660 44th St Sw Suite 100 Wyoming MI 49519-4200 Ph: (616) 974-9760 |
| NPI Number | 1467464883 |
|---|---|
| Provider Enumeration Date | 08/13/2006 |
| Last Update Date | 07/02/2009 |
| Medicare PECOS PAC ID | 6002875317 |
|---|---|
| Medicare Enrollment ID | O20041004000363 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467464883 | NPI | - | NPPES |
| 4467117 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301065270 (Michigan) | Primary |
| Provider Name | Soorya K Sharma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538171913 PECOS PAC ID: 3072572387 Enrollment ID: I20041005000190 |
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