Provider Demographics
NPI:1215558317
Name:NOVEROSKE PHILBRICK, SARAH NICOLE (DO)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:NICOLE
Last Name:NOVEROSKE PHILBRICK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 CAMPAU FARMS CIR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48207-5165
Mailing Address - Country:US
Mailing Address - Phone:574-229-5969
Mailing Address - Fax:
Practice Address - Street 1:4201 ST. ANTOINE ST
Practice Address - Street 2:RM 6G-UHC
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-966-0463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2020-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program