Individual
MRS. BETHANY ANNE MUSALLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
15125 22 MILE RD., SHELBY PEDIATRICS, SHELBY TOWNSHIP, MI 48315
(586) 532-0599
(586) 566-8967
Mailing address
15125 22 MILE RD., SHELBY PEDIATRICS, SHELBY TWP, MI 48315
(586) 532-0599
(586) 566-8967
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704244961
MI
363LP0200X
Pediatric Nurse Practitioner
Primary
4704244961
MI
Other
Enumeration date
01/29/2008
Last updated
07/29/2022
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