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Individual
MICHAEL SHANE PEER
Active
Individual
MICHAEL SHANE PEER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1195995
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1195995
NCCPA
MI
Enumeration date
06/14/2022
Last updated
06/14/2022
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