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General NPI Number Information
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NPI Number | 1336230788
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Entity Type | Organization
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Legal Business Name | SHIAWASSEE PEDIATRICS PC
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Dates
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Enumeration Date | 09/28/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 802 W KING ST SUITE C
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City | OWOSSO
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State | MI
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Zip | 48867-2100
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Country | US
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Telephone | 989-729-4848
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Fax | 989-729-4849
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Provider Business Mailing Address
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Address Line | 802 W KING ST SUITE C
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City | OWOSSO
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State | MI
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Zip | 48867-2100
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Country | US
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Telephone | 989-729-4848
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Fax | 989-729-4849
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | BARBARA J MUNSON
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Credential | MD
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Telephone | 989-729-4848
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 4301029347
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 4704113660
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License Number State | MI
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