Organization
ALLERGY & ASTHMA CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KANTI HIRALAL SHAH M.D. (PARTNERSHIP)
(734) 242-2255
Entity
Organization
Contact information
Practice address
814 N MACOMB ST, MONROE, MI 48162-2930
(734) 242-2255
(734) 243-9261
Mailing address
814 N MACOMB ST, MONROE, MI 48162-2930
(734) 242-2255
(734) 243-9261
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
4301032767
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02183
PARAMOUNT
—
01
—
0586116
BCN
—
01
—
1159
HPM
—
01
—
3505861161
BCBS
—
01
—
4054378
AETNA
—
05
—
4447580
—
MI
01
—
51988
OMNICARE
—
01
—
P00060252
RR MEDICARE
—
Enumeration date
09/16/2006
Last updated
09/14/2016
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