MEDICARE: SHERRIA E PERRY CCHW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker		MI

General Provider Information

NPI Number	:	1144045667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHERRIA E PERRY CCHW

Provider Business Mailing Address
First Line	:	30150 PALMER BLVD
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-1826
Country	:	US
Telephone Number	:	313-454-6051
Fax Number	:

Provider Business Practice Location Address
First Line	:	30150 PALMER BLVD
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-1826
Country	:	US
Telephone Number	:	313-454-6051
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2024
Last Update Date	:	11/19/2024

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Directions to “ SHERRIA E PERRY CCHW” Practice Location

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