Provider Demographics
NPI:1699976175
Name:SHARPE, REGINALD DENNIS (DO)
Entity type:Individual
Prefix:
First Name:REGINALD
Middle Name:DENNIS
Last Name:SHARPE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:15515 WINDMILL POINTE DR
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48230-1856
Mailing Address - Country:US
Mailing Address - Phone:313-580-0660
Mailing Address - Fax:734-261-2748
Practice Address - Street 1:27549 6 MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3834
Practice Address - Country:US
Practice Address - Phone:734-261-3430
Practice Address - Fax:734-261-2748
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101010839207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology