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General NPI Number Information
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NPI Number | 1215962345
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Entity Type | Organization
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Legal Business Name | SHIRLEY T SHERROD MD PC
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 04/08/2013
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Provider Practice Location Address
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Address Line | 22200 W 11 MILE RD BOX NO. 515
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City | SOUTHFIELD
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State | MI
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Zip | 48037-7136
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Country | US
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Telephone | 313-320-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 22200 W 11 MILE RD BOX NO. 515
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City | SOUTHFIELD
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State | MI
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Zip | 48037-7136
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Country | US
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Telephone | 313-320-7200
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Fax |
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Authorized Official
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Title or Position | MD
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Name | DR. SHIRLEY T SHERROD
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Credential | MD
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Telephone | 313-320-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 4301033837
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License Number State | MI
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