Individual
SHYLA R VENGALIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
22151 MOROSS RD, SUITE 320, DETROIT, MI 48236-2167
(313) 343-7374
(313) 343-7072
Mailing address
22151 MOROSS RD, SUITE 320, GROSSE POINTE WOODS, MI 48236-2167
(313) 343-7374
(313) 343-7072
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
4301056978
MI
207VM0101X
Maternal & Fetal Medicine Physician
Primary
4301056978
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4408530
ECFMG
—
Enumeration date
09/19/2005
Last updated
01/16/2015
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