Individual
DR. SUGANDH D SHETTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
31157 WOODWARD AVE, ROYAL OAK, MI 48073-0926
(248) 336-0123
(248) 336-3190
Mailing address
31157 WOODWARD AVE, ROYAL OAK, MI 48073-0926
(248) 336-0123
(248) 336-3190
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
4301058781
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
131406
PREFERRED CARE CHOICES
MI
01
—
3406338651
BCBSM INDIVIDUAL NUMBER
MI
05
—
4202425
—
MI
05
—
4973480
—
MI
01
—
5809584
AETNA
MI
01
—
C7348
MCARE PIN
MI
01
—
G84304
HAP
MI
01
—
SS058781
BCBSM LICENSE NUMBER
MI
Enumeration date
11/07/2005
Last updated
07/14/2007
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