Organization
SHIVANA N. PRAKASH MDPC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIVANA N PRAKASH MD (GENERAL SURGEON)
(586) 263-8555
Entity
Organization
Contact information
Practice address
43311 COMMONS DR, CLINTON TWP, MI 48038-1109
(586) 263-8555
(586) 263-8558
Mailing address
43311 COMMONS DR, CLINTON TWP, MI 48038-1109
(586) 263-8555
(586) 263-8558
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
SP407447
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3180584
—
MI
Enumeration date
01/08/2007
Last updated
10/30/2024
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