Individual
DR. HASNAIN HAIDER-SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., C.M.
Contact information
Practice address
580 W COLLEGE AVE, MARQUETTE, MI 49855-2705
(906) 225-7808
Mailing address
2837 US 41 W, MARQUETTE, MI 49855-2252
(906) 225-3964
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
4301076478
MI
2085R0204X
Vascular & Interventional Radiology Physician
Primary
4301076478
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4983870
—
MI
05
—
4983898
—
MI
Enumeration date
02/06/2007
Last updated
05/29/2009
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