Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0011X | Interventional Cardiology | 4301079133 | MI |
NPI | 1033105242 |
---|---|
Provider Name | Dr. Manoj Sharma |
First Address | Saginaw, MI 48602-4727 |
Second Address | Saginaw, MI 48604-2802 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2005 |
Last Update Date | 26/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1033105242 | (05) | MI |
G22276 | (02) | |
MS079133 | LICENSE # (01) | MI |