MEDICARE: SHEILA ZWIESELE MS

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	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1356780589
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEILA ZWIESELE MS

Provider Business Mailing Address
First Line	:	1355 BOGUE ST
Second Line	:	ROOM B207
City	:	EAST LANSING
State	:	MI
Zip	:	48824-6221
Country	:	US
Telephone Number	:	517-432-2851
Fax Number	:

Provider Business Practice Location Address
First Line	:	1355 BOGUE ST
Second Line	:	ROOM B207
City	:	EAST LANSING
State	:	MI
Zip	:	48824-6221
Country	:	US
Telephone Number	:	517-432-2851
Fax Number	:

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

Provider Enumeration Date	:	06/20/2013
Last Update Date	:	06/20/2013

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