Individual
LEILA AKHAVAN SHAHR ASHOUB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
14523 NORTHLINE ROAD, SOUTHGATE, MI 48195
(734) 324-7800
Mailing address
2621 HIDDEN WOODS DR, CANTON, MI 48188-2477
(315) 744-3132
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006967
MI
Other
Enumeration date
04/16/2014
Last updated
04/23/2015
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