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Individual

SHERRI S VAZALES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
14695 PARK AVE STE A, CHARLEVOIX, MI 49720
(231) 547-2812
Mailing address
1105 SIXTH ST, TRAVERSE CITY, MI 49684-2345
(231) 392-0421
(231) 935-5885

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301074823
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
070015180
RR MEDICARE
MI
05
4230205
MI
Enumeration date
05/18/2006
Last updated
11/13/2019
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