Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 4301106873 | MI |
NPI | 1558773440 |
---|---|
Provider Name | Yashesh Ilesh Shah |
First Address | Ann Arbor, MI 48108-1633 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2014 |
Last Update Date | 11/07/2019 |