Provider Demographics
NPI:1619776937
Name:MCCALL, DEBORAH SHAWNTAE
Entity type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:SHAWNTAE
Last Name:MCCALL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22777 HARPER AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48080-1846
Mailing Address - Country:US
Mailing Address - Phone:313-685-7332
Mailing Address - Fax:586-552-5634
Practice Address - Street 1:22777 HARPER AVE STE 207
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-1846
Practice Address - Country:US
Practice Address - Phone:313-685-7332
Practice Address - Fax:586-552-5634
Is Sole Proprietor?:No
Enumeration Date:2025-03-10
Last Update Date:2025-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI372500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider