Organization
SHIRLEY T SHERROD MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHIRLEY T SHERROD MD (MD)
(313) 320-7200
Entity
Organization
Contact information
Practice address
22200 W 11 MILE RD, BOX NO. 515, SOUTHFIELD, MI 48037-7136
(313) 320-7200
Mailing address
22200 W 11 MILE RD, BOX NO. 515, SOUTHFIELD, MI 48037-7136
(313) 320-7200
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301033837
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1097952 10
—
MI
01
—
1213150005
WELLNESS PLAN PIN
MI
01
—
122752
GREAT LAKES HEALTH PLAN PIN
MI
01
—
1808205381
BLUE CROSS BLUE SHIELD
MI
01
—
48818
OMNICARE COVENTRY PIN
MI
01
—
5536239
AETNA PIN
MI
01
—
B43583
HEALTH ALLIANCE PLAN PIN
MI
Enumeration date
07/11/2006
Last updated
04/08/2013
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