Individual
DIVYABEN R SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2600 MARCUS DR, TROY, MI 48083-2418
(586) 552-9239
Mailing address
2600 MARCUS DR, TROY, MI 48083-2418
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704281532
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704281532
NURSING LICENSE
MI
Enumeration date
11/01/2018
Last updated
11/01/2018
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