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Individual

MAMTA SHARMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
19251 MACK AVE, GROSSE POINTE WOODS, MI 48236-2893
(313) 343-7280
(313) 343-7921
Mailing address
43800 GARFIELD RD, CLINTON TWP, MI 48038-1136
(586) 228-4635
(586) 228-4520

Taxonomy

Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
4301067180
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05274626
ECFMG
01
4301067180
CONTROLLED SUBSTANCE
05
4466620
MI
Enumeration date
08/30/2005
Last updated
07/09/2008
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