# ARCHIBALD W. DETTMAN

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Shiawassee Family Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184642886
- **Authorized official:** DR. ARCHIBALD W. DETTMAN D.O. (OWNER)
- **Authorized official phone:** (989) 743-3415

## Contact information

- **Practice address:** 115 N SHIAWASSEE ST, CORUNNA, MI 48817-1435
- **Practice address phone:** (989) 743-3415
- **Practice address fax:** (989) 743-6180
- **Mailing address:** 115 N SHIAWASSEE ST, CORUNNA, MI 48817-1435
- **Mailing address phone:** (989) 743-3415
- **Mailing address fax:** (989) 743-6180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 5101006898 | MI | Yes |

## Other

- **Enumeration date:** 07/18/2006
- **Last updated:** 06/16/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | CH2727 | TRAVELERS MC GROUP NUMBER | MI |