Organization
SPIRO AND SHANBOM MD PC
Active
Other names
Shanbom Eye Specialist
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN ADAM SHANBOM MD (PRESIDENT)
(248) 546-2133
Entity
Organization
Contact information
Practice address
28747 WOODWARD AVE, BERKLEY, MI 48072-0914
(248) 546-2133
(248) 546-6036
Mailing address
28747 WOODWARD AVE, BERKLEY, MI 48072-0914
(248) 546-2133
(248) 546-6036
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301054486
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104141179
—
MI
01
—
CA2010
RAILROAD MEDICARE
MI
Enumeration date
05/02/2007
Last updated
06/10/2014
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