Provider Demographics
NPI:1568652410
Name:DOERR, ADRIENNE MARIE (PA)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:MARIE
Last Name:DOERR
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:54549 STILLWATER DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-6105
Mailing Address - Country:US
Mailing Address - Phone:248-918-7411
Mailing Address - Fax:
Practice Address - Street 1:133 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-2308
Practice Address - Country:US
Practice Address - Phone:586-465-1326
Practice Address - Fax:586-465-0329
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2013-03-26
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant