Provider Demographics
NPI:1821253022
Name:JOSEY, SHERUNDA SIMONE (DPM, MPH)
Entity Type:Individual
Prefix:DR
First Name:SHERUNDA
Middle Name:SIMONE
Last Name:JOSEY
Suffix:
Gender:F
Credentials:DPM, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18161 W 13 MILE RD
Mailing Address - Street 2:SUITE D-2
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-1113
Mailing Address - Country:US
Mailing Address - Phone:513-205-6363
Mailing Address - Fax:248-258-6779
Practice Address - Street 1:18161 W 13 MILE RD
Practice Address - Street 2:SUITE D-2
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-1113
Practice Address - Country:US
Practice Address - Phone:513-205-6363
Practice Address - Fax:248-258-6779
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD001167213ES0103X
PASC006084213ES0103X
MI5901002465213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I484662OtherMEDICARE PTAN