Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 4301095332 | MI |
N | 208600000X | Surgeon | 4301095332 | MI |
Y | 2086S0129X | Vascular Surgeon | 4301095332 | MI |
NPI | 1003956038 |
---|---|
Provider Name | Mr. Chinmaya Suhas Shelgikar |
First Address | Ann Arbor, MI 48105-9484 |
Second Address | Ypsilanti, MI 48197-8633 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/02/2007 |
Last Update Date | 24/07/2014 |