NPI Registry.org

Shaletta Mougoue

NPI Registration Record

Provider / OrganizationNPIDate Certified
SHALETTA MOUGOUE15680834262022-06-19

Shaletta Mougoue [F] graduated in 2020 and primarily specializes in Physician Assistant.

Shaletta Mougoue is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1568083426. Registration indicates Shaletta Mougoue is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (Physician Assistant, ) (Physician Assistants & Advanced Practice Nursing Providers, Physician Assistant) (All Other Specialties & Provider Types, ) (Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers)

PECOS ID4880018092
RegistrationPART-B:Y
DME:Y
HHA:Y
PMD:Y
Entity TypeIndividual
Provider Name Shaletta Mougoue PA-C
Practice Office Address6777 W MAPLE RD
WEST BLOOMFIELD, MI US
Practice Office Telephone2483251000
Mailing Address6777 W MAPLE RD
WEST BLOOMFIELD, MI 483223013 US
Business Telephone3134920080
Offices / Locations
AddressCity / StatePhone / Fax
6777 W Maple Rd West Bloomfield, MI 483223013 2483251000
Contact Endpoints
Direct Messaging Address [][email protected]Direct
Direct Messaging Address [][email protected]Direct
Direct Messaging Address [][email protected]
Direct Messaging Address [][email protected]Direct
HPT Codes
CodePractice
License No
State
363A00000X PRIMARYAccess to Adult/Geriatric Primary Care Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician AssistantAccess to Pediatric Primary Care Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistant
Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers
Physician Assistant
All Other Specialties & Provider Types

Physician Assistant
Physician Assistants & Advanced Practice Nursing Providers
5601009964
MI
OPI Codes
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