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General NPI Number Information
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NPI Number | 1285718759
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Entity Type | Organization
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Legal Business Name | SHISHIR SENAPATI MD PC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 07/08/2015
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Provider Practice Location Address
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Address Line | 43211 DALCOMA DR #3
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City | CLINTON TWP
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State | MI
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Zip | 48038-6309
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Country | US
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Telephone | 586-263-9355
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Fax | 586-979-9810
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Provider Business Mailing Address
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Address Line | 43211 DALCOMA DR #3
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City | CLINTON TWP
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State | MI
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Zip | 48038-6309
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Country | US
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Telephone | 586-263-9355
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Fax | 586-263-6835
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. SHISHIR K SENAPATI
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Credential | MD
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Telephone | 586-284-9444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 55066528
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License Number State | MI
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