Individual
MRS. MANJALI SUSHIL SHASTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1787 S M 52, OWOSSO, MI 48867-9201
(989) 729-4600
(989) 725-5760
Mailing address
1787 S M 52, OWOSSO, MI 48867-9201
(989) 729-4600
(989) 725-5760
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301069446
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4552316
—
MI
Enumeration date
09/07/2006
Last updated
03/26/2024
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