Provider Demographics
NPI:1821358029
Name:SHERENIAN, MICHAEL GREGOR (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GREGOR
Last Name:SHERENIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVENUE
Mailing Address - Street 2:ML 2000
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-6771
Mailing Address - Fax:513-636-5835
Practice Address - Street 1:225 E CHICAGO AVE # 60
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611
Practice Address - Country:US
Practice Address - Phone:312-227-6010
Practice Address - Fax:312-227-9401
Is Sole Proprietor?:No
Enumeration Date:2012-05-22
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.1339162080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program