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General NPI Number Information
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NPI Number | 1285717249
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Entity Type | Organization
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Legal Business Name | INSTITUTE OF NEUROMUSCULAR MEDICINE, PLLC
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 08/21/2019
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Provider Practice Location Address
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Address Line | 4300 MARSEILLES ST
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City | DETROIT
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State | MI
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Zip | 48224-1479
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Country | US
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Telephone | 313-290-2250
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Fax | 313-290-2257
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Provider Business Mailing Address
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Address Line | 4300 MARSEILLES ST
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City | DETROIT
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State | MI
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Zip | 48224-1479
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Country | US
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Telephone | 313-290-2250
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Fax | 313-290-2257
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MR. HARDIK M SHAH
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Credential | D.O.
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Telephone | 313-290-2250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number |
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License Number State |
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