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General NPI Number Information
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NPI Number | 1922185305
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Entity Type | Organization
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Legal Business Name | HEALTH SPECIALISTS OF LENAWEE P C
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 05/29/2009
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Provider Practice Location Address
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Address Line | 6869 OCCIDENTAL HIGHWAY
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City | TECUMSEH
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State | MI
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Zip | 49286-0130
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Country | US
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Telephone | 517-423-6803
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Fax | 517-423-7257
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Provider Business Mailing Address
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Address Line | PO BOX 130
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City | TECUMSEH
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State | MI
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Zip | 49286-0130
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Country | US
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Telephone | 517-423-6803
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Fax | 517-423-7257
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DENNIS NORBERT SHELLE
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Credential | M.D.
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Telephone | 517-423-6803
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | DS047781
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | AB403854
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | BC082902
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | WR082938
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | AB074281
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License Number State | MI
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Taxonomy #6
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | LF075422
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License Number State | MI
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Taxonomy #7
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | LB008900
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License Number State | MI
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