Individual
JOSEPH SHOVAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
22101 MOROSS RD, DETROIT, MI 48236
(313) 343-4000
Mailing address
200 VIRGINIA AVE APT 8, ROYAL OAK, MI 48067-1848
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
4704295628
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704295628
MI
Other
Enumeration date
09/22/2016
Last updated
07/30/2018
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