Provider Demographics
NPI:1417275736
Name:STREUR, COURTNEY SHEPARD (MD)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:SHEPARD
Last Name:STREUR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:LEE
Other - Last Name:STREUR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3621 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-1633
Mailing Address - Country:US
Mailing Address - Phone:734-647-5299
Mailing Address - Fax:
Practice Address - Street 1:1500 EAST MEDICAL CENTER DRIVE
Practice Address - Street 2:4TH FLOOR CLINIC B CS MOTT CHILDRENS HOSPITAL RM 4807
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-4217
Practice Address - Country:US
Practice Address - Phone:734-936-7030
Practice Address - Fax:734-615-3520
Is Sole Proprietor?:No
Enumeration Date:2010-05-11
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301107151208800000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program