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Individual

ASHOK R SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3901 WALTER P CHRYSLER SERVICE DR., DETROIT, MI 48201-2167
(313) 993-3434
(313) 993-3421
Mailing address
1560 E MAPLE RD, SUITE 400-CREDENTIALING, TROY, MI 48083-1138
(313) 993-3434
(313) 993-3421

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301042096
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2122648
MI
01
260049772
MEDICARE RR PIN
MI
Enumeration date
05/03/2006
Last updated
11/02/2016
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