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NPI Code Detail

MEDICARE: SHERONETTE ANN COUSINS M.D.

MEDICARE: SHERONETTE ANN COUSINS 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
1207V00000XObstetrics & Gynecology Physician9800824NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1689650053
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHERONETTE ANN COUSINS M.D.
Provider Business Mailing Address
First Line : 1908 LENDEW ST
Second Line :
City : GREENSBORO
State : NC
Zip : 27408-7007
Country : US
Telephone Number : 336-273-2835
Fax Number : 336-273-1948
Provider Business Practice Location Address
First Line : 1126 N CHURCH ST STE 101
Second Line :
City : GREENSBORO
State : NC
Zip : 27401-1035
Country : US
Telephone Number : 336-763-1007
Fax Number : 336-763-3144
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 07/26/2021

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