Individual
MR. KEVIN MICHAEL SHADEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1040 S WINTER ST, SUITE 1022, ADRIAN, MI 49221-3867
(517) 264-0146
Mailing address
1040 S WINTER ST, SUITE 1022, ADRIAN, MI 49221-3867
(517) 264-0146
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/09/2021
Last updated
11/09/2021
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