Organization
SHIVKUMAR PRABHU, M.D., P.C.
Active
Organization
SHIVKUMAR PRABHU, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIVKUMAR PRABHU M.D. (OWNER)
(313) 832-6125
Entity
Organization
Contact information
Practice address
4160 JOHN R, SUITE 702, DETROIT, MI 48201
(313) 832-6125
Mailing address
4160 JOHN R, SUITE 702, DETROIT, MI 48201
(313) 832-6125
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
SP055656
MI
Other
Enumeration date
09/29/2006
Last updated
08/22/2020
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