Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 5101005786 | MI |
NPI | 1205920873 |
---|---|
Provider Name | Dr. Michael Sherbin |
First Address | Mount Clemens, MI 48043-5748 |
Second Address | Mount Clemens, MI 48043-5748 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 29/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040E014030 | BCBSM (01) | MI |
1208372 | (05) | MI |
1258178 | (05) | MI |
E26413 | (02) | MI |