Archibald W. Dettman

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

5101006898 Issued in MI

Legal business name

ARCHIBALD W. DETTMAN

Doing business as

Shiawassee Family Medicine

Practice address

115 N Shiawassee St
Corunna, MI 48817-1435

Phone

(989) 743-3415

Fax

(989) 743-6180

NPI assigned

Jul 18, 2006

Last updated

Jun 16, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Archibald W. Dettman, D.O.

Title

Owner

Phone

(989) 743-3415

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shiawassee Family Medicine Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gerri Lynn Hagadon-Szakal, MSN, CNP, DNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Owosso, MI
  • NPI 1831193358
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213574400000",
    "number": "1184642886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 N SHIAWASSEE ST",
            "city": "CORUNNA",
            "state": "MI",
            "postal_code": "488171435",
            "telephone_number": "989-743-3415",
            "fax_number": "989-743-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 N SHIAWASSEE ST",
            "city": "CORUNNA",
            "state": "MI",
            "postal_code": "488171435",
            "telephone_number": "989-743-3415",
            "fax_number": "989-743-6180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHIBALD W. DETTMAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-18",
        "last_updated": "2008-06-16",
        "status": "A",
        "authorized_official_last_name": "DETTMAN",
        "authorized_official_first_name": "ARCHIBALD",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-743-3415",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101006898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MC GROUP NUMBER",
            "identifier": "CH2727",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shiawassee Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Britta Ann Abood, CCC-SLP
• Heather Akers
• Katie Sue Anderson
• Jennifer L Babcock, IBCLC, CHW
• Kaitlyn Barnhart
• Lorisa Bearup
• Whittni Benjamin, LPC, NCC, CADC, CCS
• Robert Broadwell, MA, LPC

• General Practice Physician in Corunna, MI
• Providers in Corunna, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.