Provider Demographics
NPI:1679574107
Name:ELFRING, CHERYL ANN (DO)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:ANN
Last Name:ELFRING
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 HASLETT RD
Mailing Address - Street 2:
Mailing Address - City:HASLETT
Mailing Address - State:MI
Mailing Address - Zip Code:48840-7615
Mailing Address - Country:US
Mailing Address - Phone:517-374-7600
Mailing Address - Fax:517-374-9042
Practice Address - Street 1:1650 HASLETT RD
Practice Address - Street 2:
Practice Address - City:HASLETT
Practice Address - State:MI
Practice Address - Zip Code:48840-7615
Practice Address - Country:US
Practice Address - Phone:517-374-7600
Practice Address - Fax:517-374-9042
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICE012450207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI8533115640OtherBCBS
MI114523092Medicaid
MIG88174Medicare UPIN
MIN53550022Medicare ID - Type Unspecified