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General NPI Number Information
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NPI Number | 1356253496
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Entity Type | Individual
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Provider Name | ANKIT SHUKLA PHARMD
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Gender | Male
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Dates
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Enumeration Date | 09/22/2026
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Last Update Date | 09/22/2026
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Provider Practice Location Address
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Address Line | 100 MICHIGAN ST NE
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-2560
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Country | US
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Telephone | 616-391-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 6425 RIDGEMONT DR SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49546-9220
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Country | US
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Telephone | 303-517-3498
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302045745
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License Number State | MI
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