Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 4301089602 | MI |
N | 111NI0900X | Internist | 4301089602 | MI |
Y | 207RN0300X | Nephrologist | 4301089602 | MI |
NPI | 1063680189 |
---|---|
Provider Name | Mili Jay Shah |
First Address | Livonia, MI 48150-4036 |
Second Address | Livonia, MI 48150-4036 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2008 |
Last Update Date | 21/01/2021 |