MEDICARE: SHAWN ALLAN DEVARY DC

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	111N00000X	Chiropractor	2301008821	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	950F327630	OTHER	MI	BCBSM

General Provider Information

NPI Number	:	1346213360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWN ALLAN DEVARY DC

Provider Business Mailing Address
First Line	:	1121 N SAGINAW ST
Second Line	:	SUITE 2
City	:	HOLLY
State	:	MI
Zip	:	48442-1380
Country	:	US
Telephone Number	:	248-328-9291
Fax Number	:	248-328-0944

Provider Business Practice Location Address
First Line	:	1121 N SAGINAW ST
Second Line	:	SUITE 2
City	:	HOLLY
State	:	MI
Zip	:	48442-1380
Country	:	US
Telephone Number	:	248-328-9291
Fax Number	:	248-328-0944

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

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	02/16/2017

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Directions to “ SHAWN ALLAN DEVARY DC” Practice Location

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