Individual
SHOSHANA DEANN HALLOWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
29000 LITTLE MACK AVE STE B, SAINT CLAIR SHORES, MI 48081-3018
(586) 774-8811
(586) 541-0199
Mailing address
1400 SE GOLDTREE DR, SUITE 102-104, PORT ST LUCIE, FL 34952-7582
(772) 335-8446
(772) 335-8499
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301500635
MI
208600000X
Surgery Physician
ME126441
FL
Other
Enumeration date
07/15/2010
Last updated
06/28/2021
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