Individual
DR. SHAMEEM MENON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4491 VENOY RD, WAYNE, MI 48184-2530
(734) 326-5030
Mailing address
4491 VENOY RD, WAYNE, MI 48184-2530
(734) 326-5030
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301071463
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4710390
—
MI
05
—
4710406
—
MI
01
—
P00201218
RAILROAD MEDICARE
MI
Enumeration date
06/22/2006
Last updated
07/08/2007
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