Individual
MS. ANITA SHALLAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(800) 653-6568
Mailing address
1000 OAKLAND DRIVE, KALAMAZOO, MI 49008-8024
(269) 337-4400
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
4301505201
MI
390200000X
Student in an Organized Health Care Education/Training Program
4351037148
MI
Other
Enumeration date
06/24/2016
Last updated
07/21/2021
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