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General NPI Number Information
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NPI Number | 1689006090
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Entity Type | Individual
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Provider Name | AMJAD SHAHAB CNIM
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Gender | Male
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Dates
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Enumeration Date | 08/08/2013
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 45211 HELM ST
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City | PLYMOUTH
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State | MI
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Zip | 48170-6023
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Country | US
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Telephone | 734-525-9712
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Fax |
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Provider Business Mailing Address
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Address Line | 306 DAWN BROOK LN
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City | CONROE
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State | TX
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Zip | 77384-3739
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Country | US
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Telephone | 832-547-0972
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Fax | 713-581-6951
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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 | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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