Individual
BRANDY LYNNE SHATTUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M. D.
Contact information
Practice address
1322 E MICHIGAN AVE, LANSING, MI 48912-2199
(517) 364-3963
Mailing address
4000 MOUNTAIN GLADE DR, APARTMENT 4, HOLT, MI 48842-7738
(518) 542-1097
Taxonomy
Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
Primary
4301097773
MI
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
2012019898
MO
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
4301097773
MI
Other
Enumeration date
04/25/2012
Last updated
07/02/2013
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