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General NPI Number Information
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NPI Number | 1255681938
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Entity Type | Individual
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Provider Name | SHERINA ANNE HYMAN PAC
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Gender | Female
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Dates
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Enumeration Date | 09/11/2012
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Last Update Date | 02/12/2014
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Provider Practice Location Address
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Address Line | 44201 DEQUINDRE RD EMERGENCY DEPT.
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City | TROY
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State | MI
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Zip | 48085-1117
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Country | US
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Telephone | 248-964-6410
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Fax |
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Provider Business Mailing Address
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Address Line | 38935 ANN ARBOR RD CREDENTIALING DEPT.
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City | LIVONIA
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State | MI
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Zip | 48150-3397
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Country | US
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Telephone | 734-632-0175
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Fax | 734-632-0182
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5601006454
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License Number State | MI
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