Individual
CHARLENE SHARON STAFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
123 MAIN ST, STE 260, ROYAL OAK, MI 48067
(248) 971-9178
Mailing address
22681 WOODWARD AVE UNIT 20042, FERNDALE, MI 48220-7001
(248) 971-9178
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601007192
MI
Other
Enumeration date
10/21/2014
Last updated
06/17/2022
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