Provider Demographics
NPI:1629158993
Name:SCHARE, MARK BARRY (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:BARRY
Last Name:SCHARE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1777 AXTELL DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-4404
Mailing Address - Country:US
Mailing Address - Phone:248-822-6200
Mailing Address - Fax:248-822-6100
Practice Address - Street 1:1777 AXTELL DR
Practice Address - Street 2:SUITE 102
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-4404
Practice Address - Country:US
Practice Address - Phone:248-822-6200
Practice Address - Fax:248-822-6100
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301043733207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIMS043733OtherMEDICAL LICENSE
MI203482523OtherTAX IDENTIFICATION
MI160029855OtherRAILROAD MEDICARE
MI1606352880OtherBCBS OF MICHIGAN
MI1606352880OtherBCBS OF MICHIGAN
MIB48492Medicare UPIN
MI0P29230Medicare ID - Type Unspecified