Individual
MIRA MAHENDRA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2799 W GRAND BLVD # M2, DETROIT, MI 48202
(313) 916-1021
(313) 916-3264
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2689
(313) 399-7668
(313) 916-3264
Taxonomy
Speciality
Code
Description
License number
State
2085R0203X
Therapeutic Radiology Physician
Primary
4301096685
MI
Other
Enumeration date
04/08/2010
Last updated
07/10/2018
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