Individual
DR. SHARON LEE TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
29255 NORTHWESTERN HWY, SUITE 100, SOUTHFIELD, MI 48034-1018
(248) 358-2410
(248) 358-2470
Mailing address
PO BOX 33321, DRAWER 117, DETROIT, MI 48232-5321
(248) 358-2410
(248) 358-2470
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301036723
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4495185-10
—
MI
Enumeration date
01/04/2006
Last updated
12/17/2010
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