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Individual

SHISHIR SENAPATI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD PC

Contact information

Practice address
43211 DALCOMA DR, #3, CLINTON TOWNSHIP, MI 48038-6309
(586) 263-9355
(586) 263-6835
Mailing address
43211 DALCOMA DR, #3, CLINTON TOWNSHIP, MI 48038-6309
(586) 263-9355
(586) 263-6835

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
SS066528
MI
208M00000X
Hospitalist Physician
4301066528
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0501580
BCBS
MI
01
10158860001
WELLNESS PLAN
MI
01
135474
GLHP
MI
01
352243716
TAX ID
MI
05
4800058
MI
01
7995388
AETNA
MI
01
NC011918
MCARE
MI
Enumeration date
07/17/2006
Last updated
07/08/2015
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