Provider Demographics
NPI:1912079898
Name:WAUDBY, SHERYL DOREEN (RPH)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:DOREEN
Last Name:WAUDBY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-4330
Mailing Address - Country:US
Mailing Address - Phone:906-225-7500
Mailing Address - Fax:906-225-7690
Practice Address - Street 1:228 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4330
Practice Address - Country:US
Practice Address - Phone:906-225-7500
Practice Address - Fax:906-225-7690
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302023982183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist