Provider Demographics
NPI:1972652717
Name:WOLF-LITMAN, SHERRI PAM (OD)
Entity type:Individual
Prefix:
First Name:SHERRI
Middle Name:PAM
Last Name:WOLF-LITMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SHERRI
Other - Middle Name:PAM
Other - Last Name:WOLF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:5103 VILLAGE PLACE CT
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3378
Mailing Address - Country:US
Mailing Address - Phone:248-788-8980
Mailing Address - Fax:
Practice Address - Street 1:37550 6 MILE RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3923
Practice Address - Country:US
Practice Address - Phone:734-542-1086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003311152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIU84691Medicare UPIN
MIN26930010Medicare ID - Type Unspecified