Individual
MR. HARDIK M SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4300 MARSEILLES ST, DETROIT, MI 48224-1479
(313) 290-2250
(313) 290-2257
Mailing address
4300 MARSEILLES ST, DETROIT, MI 48224-1479
(313) 290-2250
(313) 290-2257
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
5101010763
MI
207Q00000X
Family Medicine Physician
HS010763
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285717249
—
MI
05
—
3439691
—
MI
01
—
383397259
TAX IDENTIFICATION
MI
Enumeration date
09/23/2005
Last updated
12/10/2018
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