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Organization
PULMONARY, INTERNAL AND EMERGENCY MEDICINE AND RADIOLOGY ASSO
Active
Organization
PULMONARY, INTERNAL AND EMERGENCY MEDICINE AND RADIOLOGY ASSO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHYAM MAHESH M.D. (PRESIDENT)
(248) 358-4783
Entity
Organization
Contact information
Practice address
26699 W 12 MILE RD, SUITE 101, SOUTHFIELD, MI 48034-1578
(248) 358-4783
(248) 359-1491
Mailing address
26699 W 12 MILE RD, SUITE 101, SOUTHFIELD, MI 48034-1578
(248) 358-4783
(248) 359-1491
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
MI
207R00000X
Internal Medicine Physician
Primary
—
MI
207RP1001X
Pulmonary Disease Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
MI
Other
Enumeration date
02/03/2017
Last updated
02/10/2017
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