MEDICARE: CHRIS SHAMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	5302042969	MI

General Provider Information

NPI Number	:	1073970158
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRIS SHAMAN

Provider Business Mailing Address
First Line	:	2567 E MAPLE RD
Second Line	:	APT 3
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-5971
Country	:	US
Telephone Number	:	518-505-9287
Fax Number	:

Provider Business Practice Location Address
First Line	:	450 E CHICAGO ST
Second Line	:
City	:	COLDWATER
State	:	MI
Zip	:	49036-2003
Country	:	US
Telephone Number	:	517-278-7342
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/20/2016
Last Update Date	:	01/20/2016

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Directions to “ CHRIS SHAMAN ” Practice Location

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