Organization
ADULT & PEDIATRIC EAR, NOSE & THROAT PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELY SHAPIRO M.D. (OWNER/PHYSICIAN)
(269) 343-1296
Entity
Organization
Contact information
Practice address
501 S DRAKE RD, KALAMAZOO, MI 49009-3234
(269) 343-1296
(269) 344-8485
Mailing address
501 S DRAKE RD, KALAMAZOO, MI 49009-3234
(269) 343-1296
(269) 344-8485
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
4301072999
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1154359149
NPI
MI
Enumeration date
08/15/2007
Last updated
08/15/2007
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