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Organization
ARCHIBALD W. DETTMAN
Active
Organization
ARCHIBALD W. DETTMAN
Active
Other names
Shiawassee Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ARCHIBALD W. DETTMAN D.O. (OWNER)
(989) 743-3415
Entity
Organization
Contact information
Practice address
115 N SHIAWASSEE ST, CORUNNA, MI 48817-1435
(989) 743-3415
(989) 743-6180
Mailing address
115 N SHIAWASSEE ST, CORUNNA, MI 48817-1435
(989) 743-3415
(989) 743-6180
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
5101006898
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH2727
TRAVELERS MC GROUP NUMBER
MI
Enumeration date
07/18/2006
Last updated
06/16/2008
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