Provider Demographics
NPI:1295958221
Name:CHERYL D LERCHIN MD PLC
Entity type:Organization
Organization Name:CHERYL D LERCHIN MD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:DEBORAH
Authorized Official - Last Name:LERCHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:586-532-9959
Mailing Address - Street 1:45710 SCHOENHERR RD
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-6033
Mailing Address - Country:US
Mailing Address - Phone:586-532-9959
Mailing Address - Fax:586-566-6772
Practice Address - Street 1:45710 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-6033
Practice Address - Country:US
Practice Address - Phone:586-532-9959
Practice Address - Fax:586-566-6772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-10
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301067685208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIH14128Medicare UPIN
MION57970Medicare ID - Type Unspecified