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ARCHIBALD W. DETTMAN NPI 1184642886


NPI Information

NPI: 1184642886
Provider Name: ARCHIBALD W. DETTMAN

Doing Business As: SHIAWASSEE FAMILY MEDICINE

Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
115 N SHIAWASSEE ST
CORUNNA, MI
ZIP 48817
Phone: (989) 743-3415
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ARCHIBALD W. DETTMAN is a general practice in Corunna, MI. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee ARCHIBALD W. DETTMAN NPI is 1184642886. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Shiawassee Family Medicine.

The provider's business location address is:

115 N SHIAWASSEE ST
CORUNNA, MI
ZIP 48817-435
Phone: (989) 743-3415
Fax: (989) 743-6180

The provider's authorized official is Archibald W. Dettman .
The authorized official title is Owner and has the following contact phone number (989) 743-3415.

The enumeration date for this NPI number is 7/18/2006 and was last updated on 6/16/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208D00000XGeneral Practice5101006898MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CH2727OTHERMICHIGANTRAVELERS MC GROUP NUMBER
2=========OTHERMICHIGANFEDERAL TAX ID NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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