Provider Demographics
NPI:1225018781
Name:LERNER, SANDRA SCHLEAN (DO)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:SCHLEAN
Last Name:LERNER
Suffix:
Gender:F
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:130 TOWN CENTER DR STE 203
Mailing Address - Street 2:BEAUMONT MEDICAL STAFF AFFAIRS
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-1744
Mailing Address - Country:US
Mailing Address - Phone:248-585-8218
Mailing Address - Fax:248-585-8266
Practice Address - Street 1:29645 W 14 MILE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-1666
Practice Address - Country:US
Practice Address - Phone:248-254-6000
Practice Address - Fax:248-254-6001
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2020-10-23
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Provider Licenses
StateLicense IDTaxonomies
MI5101015209207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4789086Medicaid
I30415Medicare UPIN