Individual
DR. ANDREW MICAH SHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3700 KOLBE RD, LORAIN, OH 44053-1611
(440) 960-3748
Mailing address
400 OMALLEY DR APT 406, PARMA, OH 44134-7511
(419) 705-6870
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
59.001032
OH
Other
Enumeration date
05/07/2024
Last updated
05/07/2024
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