Provider Demographics
NPI:1528021144
Name:FARMER, CHERYL (MD)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:FARMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4993
Mailing Address - Country:US
Mailing Address - Phone:734-973-4800
Mailing Address - Fax:734-973-4810
Practice Address - Street 1:1950 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-4993
Practice Address - Country:US
Practice Address - Phone:734-973-4800
Practice Address - Fax:734-973-4810
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICF046469207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI101732OtherCARE CH/PREF CH
MI4552862Medicaid
MI110H11004OtherBCBS MI GRP ID
MI0N70350 02Medicare ID - Type UnspecifiedMEDICARE
MI110H11004OtherBCBS MI GRP ID