Provider Demographics
NPI:1588797583
Name:SHETTLER, CAROLYN E (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:E
Last Name:SHETTLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:CAROLYN
Other - Middle Name:E
Other - Last Name:MAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5050 SCHAEFER RD.
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48126
Mailing Address - Country:US
Mailing Address - Phone:313-581-2600
Mailing Address - Fax:313-581-0228
Practice Address - Street 1:5050 SCHAEFER RD.
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48126
Practice Address - Country:US
Practice Address - Phone:313-581-2600
Practice Address - Fax:313-581-0228
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301403393207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine