Healthcare Provider Details

I. General information

NPI: 1366361958
Provider Name (Legal Business Name): NIRUBEN SHETH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6245 INKSTER RD
GARDEN CITY MI
48135-4001
US

IV. Provider business mailing address

41086 SCARBOROUGH LN
NOVI MI
48375-2890
US

V. Phone/Fax

Practice location:
  • Phone: 734-458-4401
  • Fax:
Mailing address:
  • Phone: 734-458-4401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302031254
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: