Individual
SHIRLEY JAYNE KOCUR
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
16267 W 14 MILE RD, SUITE 201, BEVERLY HILLS, MI 48025-3308
(248) 645-1911
(248) 645-1248
Mailing address
16267 W 14 MILE RD, SUITE 201, BEVERLY HILLS, MI 48025-3308
(248) 645-1911
(248) 645-1248
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301046713
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1940 206
—
MI
Enumeration date
02/20/2006
Last updated
07/09/2007
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