Individual
CHRISTINA MUBARAK SHANTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BOULEVARD, DETROIT, MI 48202
(313) 916-9106
(313) 916-1249
Mailing address
HENRY FORD HEALTH SYSTEM, 2799 WEST GRAND BOULEVARD, DETROIT, MI 48202
(313) 916-9106
Taxonomy
Speciality
Code
Description
License number
State
2086S0120X
Pediatric Surgery Physician
Primary
4301070255
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1396817714
GROUP NPI
MI
05
—
4735568
—
MI
05
—
4735577
—
MI
05
—
4864707
—
MI
01
—
CS070255
COMMERCIAL-COMMERCIAL NUMBER
—
Enumeration date
09/30/2005
Last updated
03/17/2008
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