| Archibald W. Dettman | |
|
115 N Shiawassee St Corunna MI 48817-1435 | |
| (989) 743-3415 | |
| (989) 743-6180 |
| Full Name | Archibald W. Dettman |
|---|---|
| Speciality | General Practice |
| Location | 115 N Shiawassee St, Corunna, Michigan |
| Authorized Official Name and Position | Archibald W. Dettman (OWNER) |
| Authorized Official Contact | 9897433415 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Archibald W. Dettman 115 N Shiawassee St Corunna MI 48817-1435 Ph: (989) 743-3415 | Archibald W. Dettman 115 N Shiawassee St Corunna MI 48817-1435 Ph: (989) 743-3415 |
| NPI Number | 1184642886 |
|---|---|
| Provider Enumeration Date | 07/18/2006 |
| Last Update Date | 06/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184642886 | NPI | - | NPPES |
| CH2727 | Other | MI | TRAVELERS MC GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 5101006898 (Michigan) | Primary |