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Individual

DR. SHANE RANDALL STARR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
9460 S SAGINAW RD STE D, GRAND BLANC, MI 48439-8207
(810) 733-7741
(810) 733-8898
Mailing address
9460 S SAGINAW RD STE D, GRAND BLANC, MI 48439-8207
(810) 733-7741
(810) 733-8898

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
2011-00006
NC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301106295
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16141
BCBSNC
NC
05
1730372913
MI
01
238727
MEDCOST
NC
05
5917026
NC
Enumeration date
08/22/2007
Last updated
09/19/2023
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