Healthcare Provider Details

I. General information

NPI: 1194166652
Provider Name (Legal Business Name): SHAWN ADAM ACHTMAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2013
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

43344 WOODWARD AVE
BLOOMFIELD HILLS MI
48302-5014
US

IV. Provider business mailing address

1135 W UNIVERSITY DR STE 175
ROCHESTER MI
48307-1893
US

V. Phone/Fax

Practice location:
  • Phone: 248-650-5861
  • Fax: 248-650-5865
Mailing address:
  • Phone: 248-650-5861
  • Fax: 248-650-5865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number5101020786
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: