Healthcare Provider Details

I. General information

NPI: 1801007620
Provider Name (Legal Business Name): VERONICA KEMERKO SESI D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 11/28/2023
Certification Date: 11/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50505 SCHOENHERR RD STE 290
SHELBY TOWNSHIP MI
48315-3141
US

IV. Provider business mailing address

50505 SCHOENHERR RD STE 290
SHELBY TOWNSHIP MI
48315-3141
US

V. Phone/Fax

Practice location:
  • Phone: 586-314-0080
  • Fax: 586-731-6257
Mailing address:
  • Phone: 586-314-0800
  • Fax: 586-731-6257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number5101016443
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: