Provider Demographics
NPI:1760462220
Name:ROSENFELD, SHERRI PAM (DO)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:PAM
Last Name:ROSENFELD
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:27275 HAGGERTY RD STE 500
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-3635
Mailing Address - Country:US
Mailing Address - Phone:248-741-6901
Mailing Address - Fax:248-721-8203
Practice Address - Street 1:17800 NEWBURGH RD STE 103
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-2794
Practice Address - Country:US
Practice Address - Phone:734-464-9540
Practice Address - Fax:734-744-8567
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101015351207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4794881Medicaid
MI4794881Medicaid