Healthcare Provider Details

I. General information

NPI: 1992036487
Provider Name (Legal Business Name): JOHN R SARCAR MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2010
Last Update Date: 01/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2033 11TH AVE
PORT HURON MI
48060-3207
US

IV. Provider business mailing address

2033 11TH AVE
PORT HURON MI
48060-3207
US

V. Phone/Fax

Practice location:
  • Phone: 810-984-1002
  • Fax: 810-984-3737
Mailing address:
  • Phone: 810-984-1002
  • Fax: 810-984-3737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301070436
License Number StateMI

VIII. Authorized Official

Name: DR. JOHN R SARCAR
Title or Position: OWNER
Credential: MD
Phone: 810-984-1002