MEDICARE: DR. CHERYL M MAZZARA M.D.

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	2084P0800X	Psychiatry Physician	4301051598	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2605015512	OTHER	MI	BCBS

General Provider Information

NPI Number	:	1497776025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHERYL M MAZZARA M.D.

Provider Business Mailing Address
First Line	:	19900 E 10 MILE RD STE 102
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48080-4412
Country	:	US
Telephone Number	:	586-776-3366
Fax Number	:	586-776-3369

Provider Business Practice Location Address
First Line	:	19900 E 10 MILE RD STE 102
Second Line	:
City	:	SAINT CLAIR SHORES
State	:	MI
Zip	:	48080-4412
Country	:	US
Telephone Number	:	586-776-3366
Fax Number	:	586-776-3369

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	10/11/2012

Similar Medicare Providers

1174527436 — DR. DESANKA STIPIC-PETROVIC M.D.
Practice Location Address:

19900 E. 10 MILE ROAD , SUITE 102
ST. CLAIR SHORES, MI
48080-4412

Practice Phone: 586-776-3366
Practice Fax: 586-774-1808

1912946971 — DR. JEFFREY SCOTT DEGROAT PH.D.
Practice Location Address:

19900 E 10 MILE RD , SUITE 102
SAINT CLAIR SHORES, MI
48080-4412

Practice Phone: 586-776-3366
Practice Fax: 586-776-3369

1194831305 — DR. PATRICIA KOESTER DICKSON PHD
Practice Location Address:

19900 E 10 MILE RD STE 102
SAINT CLAIR SHORES, MI
48080-4412

Practice Phone: 586-776-3366
Practice Fax: 586-776-3369

1881703858 — DR. RONALD HAROLD BOARDWAY PHD
Practice Location Address:

19900 E 10 MILE RD STE 102
SAINT CLAIR SHORES, MI
48080-4412

Practice Phone: 586-776-3666
Practice Fax: 586-776-3369

1598939274 — INTEGRATIVE COUNSELING SERVICES LLC
Practice Location Address:

19900 E 10 MILE RD , SUITE 102
SAINT CLAIR SHORES, MI
48080-4412

Practice Phone: 586-491-2040
Practice Fax:

1649551268 — MRS. LORETTA MITTON MA, LLP
Practice Location Address:

19900 E 10 MILE RD , SUITE 102
SAINT CLAIR SHORES, MI
48080-4412

Practice Phone: 586-776-3366
Practice Fax:

Directions to “ DR. CHERYL M MAZZARA M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.