Provider Demographics
NPI:1770746091
Name:SHEREMETA, CHRISTINE RUTH
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:RUTH
Last Name:SHEREMETA
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CHRISTINE
Other - Middle Name:RUTH
Other - Last Name:SASS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:34504 SAINT MARTINS ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-1113
Mailing Address - Country:US
Mailing Address - Phone:248-910-0494
Mailing Address - Fax:248-582-9760
Practice Address - Street 1:34504 SAINT MARTINS ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1113
Practice Address - Country:US
Practice Address - Phone:248-910-0494
Practice Address - Fax:248-582-9760
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI586342133V00000X, 133VN1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Renal