Healthcare Provider Details

I. General information

NPI: 1376239772
Provider Name (Legal Business Name): COURTNEY MARIE SHERICK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2023
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 BEAUBIEN ST
DETROIT MI
48201-2196
US

IV. Provider business mailing address

3901 BEAUBIEN ST
DETROIT MI
48201-2196
US

V. Phone/Fax

Practice location:
  • Phone: 313-745-5533
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301517657
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: