Healthcare Provider Details

I. General information

NPI: 1215558317
Provider Name (Legal Business Name): SARAH NICOLE NOVEROSKE PHILBRICK DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2020
Last Update Date: 05/07/2025
Certification Date: 05/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16001 W 9 MILE RD
SOUTHFIELD MI
48075-4818
US

IV. Provider business mailing address

1916 CAMPAU FARMS CIR
DETROIT MI
48207-5165
US

V. Phone/Fax

Practice location:
  • Phone: 248-849-3000
  • Fax:
Mailing address:
  • Phone: 574-229-5969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number5101027242
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: