Provider Demographics
NPI:1033166590
Name:SEROTE, WILLIAM M (DO)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:M
Last Name:SEROTE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:385 MELINDA CIR
Mailing Address - Street 2:
Mailing Address - City:WHITE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:48386-3461
Mailing Address - Country:US
Mailing Address - Phone:248-698-9614
Mailing Address - Fax:
Practice Address - Street 1:461 W HURON ST
Practice Address - Street 2:NOMC EMERCENCY CENTER
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48341-1601
Practice Address - Country:US
Practice Address - Phone:248-857-7440
Practice Address - Fax:248-857-6992
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101006868207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIE37394Medicare UPIN
MION57910009Medicare ID - Type Unspecified