Shannon R Bieber, PA-C

Individual provider Active NPI Physician Assistant · Petoskey, MI

NPI 1821273798 · NPPES record last updated Aug 22, 2013

Key facts

NPI
1821273798
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
5601005045 (MI)
Practice address
1114 Charlevoix Ave
Petoskey, MI 49770-9701
Phone
(231) 439-9700
Fax
(231) 439-9709
NPI assigned
Jan 9, 2008
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)
Yes

State licenses

LicenseStateTypeSpecialty
5601005045MIMDPhysician Assistant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601005045 MI Yes

Addresses

Primary practice location

1114 Charlevoix Ave
Petoskey, MI 49770-9701

Mailing address

1114 Charlevoix Ave
Petoskey, MI 49770-9701
Phone (231) 439-9700

Other names

  • Shannon R Parent Former name

Other providers in Petoskey, MI

All providers in Petoskey, MI · Physician Assistant in Michigan

Sources for this page

Verify at the official NPI Registry.