Individual provider · Type 1 NPI
Mira Mahendra Shah, MD
Therapeutic Radiology Physician · Detroit, MI
NPI number
1740506351
Active
Practice location
2799 W Grand Blvd # M2
Detroit, MI 48202
Fax (313) 916-3264
Mailing address
2799 W Grand Blvd
Detroit, MI 48202-2689
Other practice locations
- 6777 W Maple Rd, West Bloomfield, MI 48322-3013 · (248) 661-6487
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Therapeutic Radiology Physician Primary | 2085R0203X | 4301096685 (MI) |
Therapeutic Radiology Physician: Therapeutic Radiology certificate name was changed to Radiation Oncology. Use Radiation Oncology.
About NPI 1740506351
Mira Mahendra Shah, MD's National Provider Identifier is 1740506351, issued on Apr 8, 2010. The primary taxonomy on file is Therapeutic Radiology Physician (2085R0203X), and the practice location is in Detroit, MI. The record was last updated on Jul 10, 2018.