Doctor Name: | SHERITTA MARIE BUFORD |
NPI Number: | 1144677915 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MT |
License Number: | 7501009330 |
Business Practice Address: | 21331 Kelly Rd Eastpointe, MI - 480213265 |
Business Phone Number: | 3132931054 |
Business Fax Number: | 8664663087 |
Mailing Address: | 13960 Mettetal St, DETROIT |
State: | MI |
Postal Code: | 482271747 |
Phone Number: | 3132931054 |
Fax Number: | 8664663087 |
NPI Enumeration Date: | 05/20/2016 |
NPI Last Update Date: | 05/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 7501009330 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |