Provider Demographics
NPI:1376566596
Name:FINE, RICHARD SHERMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:SHERMAN
Last Name:FINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:794 CANTERBURY RD
Mailing Address - Street 2:
Mailing Address - City:GROSSE POINTE WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48236-1280
Mailing Address - Country:US
Mailing Address - Phone:586-779-9710
Mailing Address - Fax:313-290-2956
Practice Address - Street 1:794 CANTERBURY RD
Practice Address - Street 2:
Practice Address - City:GROSSE POINTE WOODS
Practice Address - State:MI
Practice Address - Zip Code:48236-1280
Practice Address - Country:US
Practice Address - Phone:586-779-9710
Practice Address - Fax:313-290-2956
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI035972207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2108943Medicaid
A76684Medicare UPIN
MI2108943Medicaid