Individual
SHYAM SUNDER MOUDGIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25195 KELLY RD, SUITE B, ROSEVILLE, MI 48066-4909
(586) 777-3370
(586) 777-3380
Mailing address
25195 KELLY RD, SUITE B, ROSEVILLE, MI 48066-4909
(586) 777-3370
(586) 777-3380
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301069080
MI
2084N0400X
Neurology Physician
Primary
4301069080
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4399330
—
MI
Enumeration date
08/30/2006
Last updated
03/02/2017
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