Individual
KRISTINE SHANGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
811 SOUTH BLVD E STE 200, ROCHESTER HILLS, MI 48307-5359
(248) 651-0800
Mailing address
7454 TIMBERS EDGE BLVD, WEST BLOOMFIELD, MI 48322-3335
(248) 866-9098
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601012712
MI
Other
Enumeration date
09/04/2024
Last updated
09/08/2024
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