# SACRED HEART MEDICAL GROUP

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** SHMG Endocrinology-Dr. Mamish
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083383517
- **Authorized official:** JEAN VALLIER (DIRECTOR)
- **Authorized official phone:** (850) 416-5450

## Contact information

- **Practice address:** 1549 AIRPORT BLVD STE 330, PENSACOLA, FL 32504-8635
- **Practice address phone:** (850) 416-5450
- **Mailing address:** 4205 BELFORT RD STE 4015, JACKSONVILLE, FL 32216-3623

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/08/2021
- **Last updated:** 09/08/2021