Provider Demographics
NPI:1235133703
Name:VEREMIS-LEY, MARY GEORGIA (DO)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:GEORGIA
Last Name:VEREMIS-LEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:GEORGIA
Other - Last Name:VEREMIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:43900 GARFIELD RD
Mailing Address - Street 2:STE 100
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1137
Mailing Address - Country:US
Mailing Address - Phone:586-286-2544
Mailing Address - Fax:586-286-0534
Practice Address - Street 1:43900 GARFIELD RD
Practice Address - Street 2:STE 100
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-1137
Practice Address - Country:US
Practice Address - Phone:586-286-2544
Practice Address - Fax:586-286-0534
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101015072207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology