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General NPI Number Information
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NPI Number | 1932393519
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Entity Type | Individual
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Provider Name | KANCHI MAYA SHERPA MD.
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Gender | Female
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 06/24/2011
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Provider Practice Location Address
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Address Line | 4646 JOHN R ST JOHN D. DINGELL VA MEDICAL CENTER
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City | DETROIT
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State | MI
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Zip | 48201-1916
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Country | US
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Telephone | 313-576-1000
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Fax | 313-576-1233
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Provider Business Mailing Address
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Address Line | 744 SHELDEN RD
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City | GROSSE POINTE SHORES
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State | MI
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Zip | 48236-1511
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Country | US
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Telephone | 248-990-3018
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Fax | 313-447-5846
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 241910
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207U00000X
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Taxonomy Name | Nuclear Medicine Physician
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License Number | 241910
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License Number State | NY
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