MEDICARE: MS. SHEILA JAMALUDDIN BHARMAL M.D.

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	207RG0100X	Gastroenterology Physician	63870	MN

General Provider Information

NPI Number	:	1922364082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHEILA JAMALUDDIN BHARMAL M.D.

Provider Business Mailing Address
First Line	:	PO BOX 14909
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-0909
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1973 SLOAN PL STE 100
Second Line	:
City	:	MAPLEWOOD
State	:	MN
Zip	:	55117-2180
Country	:	US
Telephone Number	:	612-871-1145
Fax Number	:

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

Provider Enumeration Date	:	04/03/2012
Last Update Date	:	11/27/2018

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