Provider Demographics
NPI:1750544268
Name:ZACHARIAS, SIBIN K (MD)
Entity type:Individual
Prefix:
First Name:SIBIN
Middle Name:K
Last Name:ZACHARIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 S BALLENGER HWY
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48532-3638
Mailing Address - Country:US
Mailing Address - Phone:586-710-8300
Mailing Address - Fax:810-342-1591
Practice Address - Street 1:1030 HARRINGTON ST
Practice Address - Street 2:STE 101
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-2967
Practice Address - Country:US
Practice Address - Phone:586-464-4010
Practice Address - Fax:586-468-7997
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301092477390200000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program