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General NPI Number Information
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NPI Number | 1003787920
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Entity Type | Individual
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Provider Name | MICHELLE SHUMUNOV CNM
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Gender | Female
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Dates
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Enumeration Date | 09/15/2025
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | 32686 WOODWARD AVE
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City | ROYAL OAK
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State | MI
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Zip | 48073-0951
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Country | US
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Telephone | 248-645-0840
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Fax |
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Provider Business Mailing Address
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Address Line | 1428 S LAPEER RD
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City | LAKE ORION
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State | MI
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Zip | 48360-1437
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Country | US
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Telephone | 248-693-0543
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Fax | 248-693-3683
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | 4704431857
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License Number State | MI
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