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General NPI Number Information
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NPI Number | 1588196885
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Entity Type | Organization
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Legal Business Name | SHEAUN D PARAMEDICAL SERVICES LLC
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Dates
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Enumeration Date | 03/28/2017
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Last Update Date | 03/28/2017
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Provider Practice Location Address
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Address Line | 22013 BOULDER AVE
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City | EASTPOINTE
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State | MI
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Zip | 48021-2303
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Country | US
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Telephone | 313-289-3366
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Fax |
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Provider Business Mailing Address
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Address Line | 22013 BOULDER AVE
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City | EASTPOINTE
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State | MI
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Zip | 48021-2303
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | MR. SHEAUN ANTONIO DOUGLAS
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Credential |
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Telephone | 313-289-3366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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