Provider Demographics
NPI:1992036487
Name:JOHN R SARCAR MD PC
Entity Type:Organization
Organization Name:JOHN R SARCAR MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:SARCAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:810-984-1002
Mailing Address - Street 1:2033 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORT HURON
Mailing Address - State:MI
Mailing Address - Zip Code:48060-3207
Mailing Address - Country:US
Mailing Address - Phone:810-984-1002
Mailing Address - Fax:810-984-3737
Practice Address - Street 1:2033 11TH AVE
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3207
Practice Address - Country:US
Practice Address - Phone:810-984-1002
Practice Address - Fax:810-984-3737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010704362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2607402122OtherBCBS
MI2607402122OtherBCBS