Individual
JAISHREE TANDON-SHARMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8447 HOLLY RD, GRAND BLANC, MI 48439-1888
(810) 695-1992
(810) 695-2664
Mailing address
8447 HOLLY RD, GRAND BLANC, MI 48439-1888
(810) 695-1992
(810) 695-2664
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301073664
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982613915
—
MI
01
—
JT073664
BC/BS OF MICHIGAN
MI
Enumeration date
08/07/2006
Last updated
09/11/2010
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