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General NPI Number Information
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NPI Number | 1235134644
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Entity Type | Organization
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Legal Business Name | MARVIN SHULMAN, MD, PC
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Dates
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Enumeration Date | 06/14/2005
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Last Update Date | 12/15/2008
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Provider Practice Location Address
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Address Line | 16530 19 MILE RD
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-1106
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Country | US
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Telephone | 586-286-6600
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Fax | 586-286-3503
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Provider Business Mailing Address
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Address Line | 16530 19 MILE RD
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-1106
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Country | US
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Telephone | 586-286-6600
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Fax | 586-286-3503
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MARVIN SHULMAN
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Credential | MD
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Telephone | 586-286-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MS033963
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License Number State | MI
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