MEDICARE: SARAH TEHSEEN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	4301097223	MI

General Provider Information

NPI Number	:	1104134832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH TEHSEEN MD

Provider Business Mailing Address
First Line	:	80 E HANCOCK ST
Second Line	:	1609
City	:	DETROIT
State	:	MI
Zip	:	48201-1311
Country	:	US
Telephone Number	:	510-402-9509
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 BEAUBIEN STREET
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48201-1311
Country	:	US
Telephone Number	:	313-745-1892
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/15/2010
Last Update Date	:	11/03/2010

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Directions to “ SARAH TEHSEEN MD” Practice Location

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