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Individual

MARK A SHUNTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
499 W NORTON AVE, MUSKEGON HTS, MI 49444
(231) 733-2685
(231) 737-1236
Mailing address
499 W NORTON AVE, MUSKEGON HTS, MI 49444
(231) 733-2685
(231) 737-1236

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901002766
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
945105112
MI
01
MS002766
BCBSM
Enumeration date
08/31/2006
Last updated
01/05/2015
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