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Organization
SHORELINE ALLERGY, P.C.
Active
Organization
SHORELINE ALLERGY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. THERESE PIPP (BILLING/ACCTS MGR)
(231) 799-8777
Entity
Organization
Contact information
Practice address
6215 HARVEY ST, MUSKEGON, MI 49444-9739
(231) 799-8777
(231) 798-7423
Mailing address
6215 HARVEY ST, MUSKEGON, MI 49444-9739
(231) 799-8777
(231) 798-7423
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
FD055364
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0618234
BCBS PROVIDER
MI
05
—
3478831
—
MI
01
—
FD055634
STATE LICENSE
MI
Enumeration date
05/07/2008
Last updated
05/07/2008
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