Individual
MICHAEL SHANE PATTERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
44720 VAN DYKE AVE, UTICA, MI 48317-5480
(586) 323-7148
(586) 323-7215
Mailing address
44720 VAN DYKE AVE, UTICA, MI 48317-5480
(586) 221-2791
(586) 231-0716
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
5101014038
MI
207R00000X
Internal Medicine Physician
Primary
5101014038
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11-5501033-5
BCBS PIN
MI
01
—
700E031600
BCBS GROUP NUMBER
MI
Enumeration date
07/02/2006
Last updated
03/31/2021
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