Provider Demographics
NPI:1174626980
Name:PIERCE, SHARI ROBIN (DO)
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:ROBIN
Last Name:PIERCE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20317 FARMINGTON RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1411
Mailing Address - Country:US
Mailing Address - Phone:248-615-0777
Mailing Address - Fax:248-615-0779
Practice Address - Street 1:20317 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1411
Practice Address - Country:US
Practice Address - Phone:248-615-0777
Practice Address - Fax:248-615-0779
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101012871208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5039723OtherAETNA
MIC7825OtherMCARE
MI139929OtherCARE CHOICES
1871794OtherFIRST HEALTH
MI1158206385OtherBLUE CROSS
MIP109675OtherBLUE CARE NETWORK
G76047Medicare UPIN
MIH29992004Medicare ID - Type Unspecified