Individual
GASSAN SHAHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18025 STONEBROOK DR, NORTHVILLE, MI 48168-4345
(313) 570-2392
Mailing address
18025 STONEBROOK DR, NORTHVILLE, MI 48168-4345
(313) 570-2392
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301071918
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4846594
—
MI
01
—
70-0-F32947-0
BCBS CPIN #
MI
01
—
GS071918
BCBSM
MI
Enumeration date
09/07/2005
Last updated
03/19/2020
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