Provider Demographics
NPI:1063509974
Name:SHER, JULIE NICOLE (DO)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:NICOLE
Last Name:SHER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:NICOLE
Other - Last Name:SHERBIN-SHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:41400 DEQUINDRE RD
Mailing Address - Street 2:STE 107
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-3763
Mailing Address - Country:US
Mailing Address - Phone:586-466-5911
Mailing Address - Fax:586-466-5921
Practice Address - Street 1:41400 DEQUINDRE RD
Practice Address - Street 2:STE 107
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48314-3763
Practice Address - Country:US
Practice Address - Phone:586-466-5911
Practice Address - Fax:586-466-5921
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJS0135792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H47079Medicare UPIN
MI0P10940Medicare PIN
MIOP10940Medicare UPIN