Individual
VINCENT SHALLAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 397-8403
Mailing address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
4351046276
MI
Other
Enumeration date
06/29/2020
Last updated
06/29/2020
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