Provider Demographics
NPI:1629357686
Name:SHAMUS, NORMAN JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:JOSEPH
Last Name:SHAMUS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21780 KNUDSEN DR
Mailing Address - Street 2:
Mailing Address - City:GROSSE ILE
Mailing Address - State:MI
Mailing Address - Zip Code:48138-1346
Mailing Address - Country:US
Mailing Address - Phone:734-675-0474
Mailing Address - Fax:
Practice Address - Street 1:21780 KNUDSEN DR
Practice Address - Street 2:
Practice Address - City:GROSSE ILE
Practice Address - State:MI
Practice Address - Zip Code:48138-1346
Practice Address - Country:US
Practice Address - Phone:734-675-0474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI27271702085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology