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NPI Code Detail

MEDICARE: JAISHREE TANDON-SHARMA M.D.

MEDICARE: JAISHREE TANDON-SHARMA 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
1207Q00000XFamily Medicine Physician4301073664MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2JT073664OTHERMIBC/BS OF MICHIGAN

General Provider Information

NPI Number : 1982613915
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAISHREE TANDON-SHARMA M.D.
Provider Business Mailing Address
First Line : 8447 HOLLY RD
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-1888
Country : US
Telephone Number : 810-695-1992
Fax Number : 810-695-2664
Provider Business Practice Location Address
First Line : 8447 HOLLY RD
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-1888
Country : US
Telephone Number : 810-695-1992
Fax Number : 810-695-2664
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/07/2006
Last Update Date : 09/11/2010

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