Individual
SHANNON MCCALLUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236-2148
(313) 343-8777
Mailing address
21532 SABRINA DR, MACOMB, MI 48044-1321
(586) 949-0102
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704131498
MI
Other
Enumeration date
12/08/2006
Last updated
07/08/2007
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