Healthcare Provider Details

I. General information

NPI: 1811032485
Provider Name (Legal Business Name): SHERIDA DANIELLE DUBOSE PARSONS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SHERIDA DANIELLE DUBOSE MD

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 07/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3901 BEAUBIEN CHILDREN'S HOSPITAL OF MI
DETROIT MI
48201
US

IV. Provider business mailing address

4201 ST. ANTOINE UNIVERSITY PEDIATRICIANS UHC 5D MAILBOX# 226
DETROIT MI
48201
US

V. Phone/Fax

Practice location:
  • Phone: 313-745-4000
  • Fax:
Mailing address:
  • Phone: 313-966-5051
  • Fax: 313-966-0665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01078465
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number4301078465
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: