Provider Demographics
NPI:1831150010
Name:NORTHCROSS, GALE SHERRELL (MD)
Entity type:Individual
Prefix:DR
First Name:GALE
Middle Name:SHERRELL
Last Name:NORTHCROSS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:101 CHICAGO BLVD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-1412
Mailing Address - Country:US
Mailing Address - Phone:313-867-1118
Mailing Address - Fax:
Practice Address - Street 1:1644 STONE ST
Practice Address - Street 2:
Practice Address - City:PORT HURON
Practice Address - State:MI
Practice Address - Zip Code:48060-3344
Practice Address - Country:US
Practice Address - Phone:810-982-8016
Practice Address - Fax:810-982-8016
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010494062083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine