Individual
SHIVANHALLI PRAKASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
43311 COMMONS DR, CLINTON TWP, MI 48038-1109
(586) 263-8555
(586) 263-8558
Mailing address
43311 COMMONS DRIVE, CLINTON TOWNSHIP, MI 48038-1109
(586) 263-8555
(586) 263-8558
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
SP407447
MI
Other
Enumeration date
08/16/2006
Last updated
10/30/2024
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