Healthcare Provider Details

I. General information

NPI: 1366885824
Provider Name (Legal Business Name): SINA JAME
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2013
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 SIXTH ST STE 200
TRAVERSE CITY MI
49684-2369
US

IV. Provider business mailing address

1200 SIXTH ST STE 200
TRAVERSE CITY MI
49684-2369
US

V. Phone/Fax

Practice location:
  • Phone: 231-935-5800
  • Fax: 231-935-5799
Mailing address:
  • Phone: 231-935-5800
  • Fax: 231-935-5799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number4301109968
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number4301109968
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: