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General NPI Number Information
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NPI Number | 1467502252
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Entity Type | Organization
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Legal Business Name | MICHIGAN INTERNAL MEDICINE & PEDIATRICS, P.C.
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 9001 MILLER ROAD SUITE 5
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City | SWARTZ CREEK
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State | MI
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Zip | 48473
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Country | US
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Telephone | 810-630-0404
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Fax | 810-630-2306
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Provider Business Mailing Address
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Address Line | 9001 MILLER ROAD SUITE 5
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City | SWARTZ CREEK
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State | MI
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Zip | 48473
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Country | US
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Telephone | 810-630-0404
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Fax | 810-630-2306
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Authorized Official
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Title or Position | OWNER
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Name | DR. PUNAM SHARMAN
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Credential | M.D.
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Telephone | 810-630-0404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301072232
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301072232
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License Number State | MI
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