Provider Demographics
NPI:1184802886
Name:HEALTH SPECIALISTS OF LENAWEE, P.C.
Entity type:Organization
Organization Name:HEALTH SPECIALISTS OF LENAWEE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:NORBERT
Authorized Official - Last Name:SHELLE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:517-423-6803
Mailing Address - Street 1:6869 OCCIDENTAL HWY
Mailing Address - Street 2:PO BOX 130
Mailing Address - City:TECUMSEH
Mailing Address - State:MI
Mailing Address - Zip Code:49286
Mailing Address - Country:US
Mailing Address - Phone:517-423-6803
Mailing Address - Fax:517-423-7257
Practice Address - Street 1:6869 OCCIDENTAL HWY
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:MI
Practice Address - Zip Code:49286
Practice Address - Country:US
Practice Address - Phone:517-423-6803
Practice Address - Fax:517-423-7257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-05
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIDS047781174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI233903Medicare Oscar/Certification