Individual
MIRANDA SHERWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5901 CHASE RD STE 110, DEARBORN, MI 48126-0900
(313) 581-9446
Mailing address
5901 CHASE RD STE 110, DEARBORN, MI 48126-0900
(313) 581-9446
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601009893
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1123344567
NOT APPLICABLE
—
Enumeration date
06/27/2021
Last updated
06/27/2021
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