Individual
DR. SHAWN JEFFREY MOULDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
18101 OAKWOOD BLVD, DEARBORN, MI 48124-4089
(313) 593-7000
Mailing address
19756 S GLEN BLVD, APT C, BROWNSTOWN TWP, MI 48183-4928
(573) 280-7022
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101022023
MI
Other
Enumeration date
06/18/2015
Last updated
06/18/2015
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