| Doctor Name: | CHARLENE L. SEBEST |
| NPI Number: | 1093700981 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.A.-C |
| License Number: | 5601002989 |
| Business Practice Address: | 19229 Mack Ave Suite 24 Grosse Pointe, MI - 482362858 |
| Business Phone Number: | 3138845522 |
| Business Fax Number: | 3138846054 |
| Mailing Address: | 19229 Mack Ave, Suite 24 GROSSE POINTE |
| State: | MI |
| Postal Code: | 482362858 |
| Phone Number: | 3138845522 |
| Fax Number: | 3138846054 |
| NPI Enumeration Date: | 09/16/2005 |
| NPI Last Update Date: | 02/05/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 5601002989 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |