Organization
SHC MEDICAL PARTNERS OF MICHIGAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGIE MATTINGLY (MGR PROVIDER ENROLLMENT)
(502) 630-7425
Entity
Organization
Contact information
Practice address
28550 FIVE MILE RD, LIVONIA, MI 48154-3866
(734) 427-8270
Mailing address
805 N WHITTINGTON PKWY, LOUISVILLE, KY 40222-7101
(502) 630-7425
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/15/2023
Last updated
05/19/2026
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