Organization
MYKIDZDOC LLC
Active
Other names
MYKIDZDOC
Organization subpart
No
Provider details
NPI number
Authorized official
OSAMA SHETH (M.D)
(773) 263-8984
Entity
Organization
Contact information
Practice address
48558 WOODSON WAY, CANTON, MI 48187-6675
(773) 263-8984
Mailing address
48558 WOODSON WAY, CANTON, MI 48187-6675
(773) 263-8984
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301095767
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4301095767
—
MI
Enumeration date
02/13/2014
Last updated
03/21/2014
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