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

TaxonomyCodeLicense
Therapeutic Radiology Physician Primary 2085R0203X4301096685 (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.