Provider Demographics
NPI:1164873675
Name:CORMIER, BRIELLE RENEE (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIELLE
Middle Name:RENEE
Last Name:CORMIER
Suffix:
Gender:F
Credentials:DO
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:27555 MIDDLEBELT ROAD
Mailing Address - Street 2:
Mailing Address - City:FARMIGNTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334
Mailing Address - Country:US
Mailing Address - Phone:248-478-5512
Mailing Address - Fax:248-478-5350
Practice Address - Street 1:27555 MIDDLEBELT ROAD
Practice Address - Street 2:
Practice Address - City:FARMIGNTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334
Practice Address - Country:US
Practice Address - Phone:248-478-5512
Practice Address - Fax:248-478-5350
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI51010227432084N0400X
MI51510102282084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology