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General NPI Number Information
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NPI Number | 1063169027
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Entity Type | Organization
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Legal Business Name | SHARIOT CARE, LLC
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Dates
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Enumeration Date | 03/09/2022
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Last Update Date | 03/09/2022
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Provider Practice Location Address
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Address Line | 20755 GREENFIELD RD STE 203
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City | SOUTHFIELD
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State | MI
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Zip | 48075-5405
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Country | US
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Telephone | 248-395-2206
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Fax | 248-325-9992
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Provider Business Mailing Address
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Address Line | 20755 GREENFIELD RD STE 203
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City | SOUTHFIELD
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State | MI
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Zip | 48075-5405
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Country | US
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Telephone | 248-395-2206
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Fax | 248-325-9992
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Authorized Official
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Title or Position | OWNER/ CEO
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Name | DR. SHARON TERESA BLACKSHIRE-TUBIE
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Credential | FNP-BC
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Telephone | 248-395-2206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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