Provider Demographics
NPI:1154633899
Name:SAREEN, NISHTHA
Entity Type:Individual
Prefix:DR
First Name:NISHTHA
Middle Name:
Last Name:SAREEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 S WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48601-2556
Mailing Address - Country:US
Mailing Address - Phone:989-754-3000
Mailing Address - Fax:989-754-3015
Practice Address - Street 1:1015 S WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601-2556
Practice Address - Country:US
Practice Address - Phone:989-754-3000
Practice Address - Fax:989-754-3015
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-10
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301100167207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI50146665OtherHAP GROUP PIN
MI700H273300OtherBCBSM GROUP PIN
MIDS0605OtherRR MEDICARE GRP PIN
MI1295023547OtherGROUP NPI TYPE II (MICHIGAN HEALTHCARE PROFESSIONALS, PC
MIMI4989OtherGROUP MEDICARE PIN