Provider Demographics
NPI:1912385154
Name:SHERMAN, STEFANIE DENISE (MD)
Entity Type:Individual
Prefix:
First Name:STEFANIE
Middle Name:DENISE
Last Name:SHERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5825 S MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48346-2983
Mailing Address - Country:US
Mailing Address - Phone:248-620-3000
Mailing Address - Fax:248-620-0110
Practice Address - Street 1:5825 S MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-2983
Practice Address - Country:US
Practice Address - Phone:248-620-3000
Practice Address - Fax:248-620-0110
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301119198207W00000X
IL125066577207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology