Provider Demographics
NPI:1013127737
Name:MCRAE, SHARON LEILANI (MD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:LEILANI
Last Name:MCRAE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:21409 KELLY RD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-3264
Mailing Address - Country:US
Mailing Address - Phone:586-777-0630
Mailing Address - Fax:586-777-0631
Practice Address - Street 1:21409 KELLY RD
Practice Address - Street 2:400
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-3264
Practice Address - Country:US
Practice Address - Phone:586-777-0630
Practice Address - Fax:586-777-0631
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2014-04-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301088884207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine