Shannon Gayle Foster

Individual provider Active NPI Other Technician · Pentwater, MI

NPI 1003274846 · NPPES record last updated Feb 8, 2016

Key facts

NPI
1003274846
Entity type
Individual (NPI type 1)
Primary specialty
Other Technician 247200000X
Practice address
2960 W Adams Rd
Pentwater, MI 49449-8579
Phone
(231) 923-6167
NPI assigned
Feb 8, 2016
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Other Technician 247200000X Yes

Addresses

Primary practice location

2960 W Adams Rd
Pentwater, MI 49449-8579

Mailing address

2960 W Adams Rd
Pentwater, MI 49449-8579
Phone (231) 923-6167

Other providers in Pentwater, MI

All providers in Pentwater, MI · Other Technician in Michigan

Sources for this page

Verify at the official NPI Registry.