Individual
SHERRY LYNN DUSTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
44555 WOODWARD AVE STE 203, PONTIAC, MI 48341-5033
(248) 334-4931
(248) 239-0492
Mailing address
44555 WOODWARD AVE STE 203, PONTIAC, MI 48341-5033
(248) 334-4931
(248) 239-0492
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003679
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F38599
BLUE CROSS BLUE SHIELD MICHIGAN
MI
05
—
943239340
—
MI
Enumeration date
06/17/2006
Last updated
09/16/2022
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