MEDICARE: DR. PUNAM SHARMAN 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	207R00000X	Internal Medicine Physician	4301072232	MI
2	208000000X	Pediatrics Physician	4301072232	MI

General Provider Information

NPI Number	:	1982651881
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PUNAM SHARMAN M.D.

Provider Business Mailing Address
First Line	:	9001 MILLER RD
Second Line	:	SUITE5
City	:	SWARTZ CREEK
State	:	MI
Zip	:	48473-1115
Country	:	US
Telephone Number	:	810-630-0404
Fax Number	:	810-630-2306

Provider Business Practice Location Address
First Line	:	9001 MILLER RD
Second Line	:	SUITE 5
City	:	SWARTZ CREEK
State	:	MI
Zip	:	48473-1115
Country	:	US
Telephone Number	:	810-630-0404
Fax Number	:	810-230-2306

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

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	08/15/2011

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