Basic Information
| Provider Information | |||||||||
| NPI: | 1477548899 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SARKAR | ||||||||
| FirstName: | ARUP | ||||||||
| MiddleName: | |||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1212 W SAGINAW RD | ||||||||
| Address2: | |||||||||
| City: | VASSAR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 487689483 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9898235020 | ||||||||
| FaxNumber: | 9898237881 | ||||||||
| Practice Location | |||||||||
| Address1: | 1212 W SAGINAW RD | ||||||||
| Address2: | |||||||||
| City: | VASSAR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 487689483 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9898235020 | ||||||||
| FaxNumber: | 9898237881 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2005 | ||||||||
| LastUpdateDate: | 05/19/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 4301079750 | MI | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 4771591 | 05 | MI | MEDICAID | M10200918 | 01 | MI | HEATLHNET TRICARE | OTHER | 0807911002 | 01 | MI | BCBS OF MICHIGAN | OTHER | 080G376200 | 01 | MI | BCBSM | OTHER | 151305 | 01 | MI | GREATLAKE MEDICAID | OTHER |