Individual
TAKESHI NISHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1722 SHAFFER ST, KALAMAZOO, MI 49048-1633
(269) 226-5050
Mailing address
3245 HEALTH DR STE 100, GRANGER, IN 46530-1380
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301515140
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518724244
—
MI
Enumeration date
02/29/2024
Last updated
04/07/2026
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