Individual
GEORGIA SHEENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
19725 W 12 MILE RD, SOUTHFIELD, MI 48076-2584
(248) 770-5205
Mailing address
1576 COVINGTON RD, BLOOMFLD HLS, MI 48301-2372
(248) 935-2377
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601011479
MI
Other
Enumeration date
12/21/2022
Last updated
12/21/2022
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