Provider Demographics
NPI:1033309034
Name:SORSER, SERGE ALEXANDER (MD)
Entity Type:Individual
Prefix:DR
First Name:SERGE
Middle Name:ALEXANDER
Last Name:SORSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:26850 PROVIDENCE PKWY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-1213
Mailing Address - Country:US
Mailing Address - Phone:248-662-4110
Mailing Address - Fax:248-662-4120
Practice Address - Street 1:26850 PROVIDENCE PKWY
Practice Address - Street 2:SUITE 350
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1213
Practice Address - Country:US
Practice Address - Phone:248-662-4110
Practice Address - Fax:248-662-4120
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2014-09-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301090772207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0930826OtherBLUE CARE NETWORK
MI020E039180OtherBLUE CROSS BLUE SHIELD MI
MI1033309034Medicaid
P49480037Medicare PIN