Provider Demographics
NPI:1013026855
Name:NORTH OAKLAND EAR NOSE &THROAT CENTERS PC
Entity Type:Organization
Organization Name:NORTH OAKLAND EAR NOSE &THROAT CENTERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHERMETARO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-620-3100
Mailing Address - Street 1:5701 BOW POINTE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-3198
Mailing Address - Country:US
Mailing Address - Phone:248-620-3100
Mailing Address - Fax:248-620-3019
Practice Address - Street 1:5701 BOW POINTE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-3198
Practice Address - Country:US
Practice Address - Phone:248-620-3100
Practice Address - Fax:248-620-3019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1013026855Medicaid
MI040F374250OtherBLUE CROSS BLUE SHIELD