Individual
SHRUTI MISHRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-4000
Mailing address
3621 S STATE ST, ANN ARBOR, MI 48108-1633
(734) 647-5299
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.070165
IL
2085R0202X
Diagnostic Radiology Physician
Primary
4301509657
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125.070165
IDFPR
IL
Enumeration date
06/19/2017
Last updated
08/02/2023
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