Individual
SHANTI THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
19725 ALLEN RD STE 101, BROWNSTOWN TWP, MI 48183-1090
(734) 479-2371
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
Primary
4301055015
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4695453
—
MI
01
—
P00139598
US RAILROAD RETIREMENT
MI
Enumeration date
10/02/2006
Last updated
08/05/2025
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