Provider Demographics
NPI:1437786019
Name:SHEREMETA, GREGORY (DPM)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:SHEREMETA
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 INVESTMENT DR STE 280
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-6362
Mailing Address - Country:US
Mailing Address - Phone:248-312-0767
Mailing Address - Fax:
Practice Address - Street 1:4550 INVESTMENT DR STE 280
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-6362
Practice Address - Country:US
Practice Address - Phone:248-312-0767
Practice Address - Fax:248-312-0840
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI5901400483213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program