Individual
DR. SHANNON THOMAS RADGENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
818 W KING ST, SUITE 301, OWOSSO, MI 48867-2116
(989) 729-4800
(989) 729-4810
Mailing address
818 W KING ST, SUITE 301, OWOSSO, MI 48867-2116
(989) 729-4800
(989) 729-4810
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
5101013241
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4616511
—
MI
Enumeration date
08/19/2006
Last updated
02/14/2013
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