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NPI Code Detail

MEDICARE: DR. SHAI MOSHE BROSH PHD

MEDICARE:  DR. SHAI MOSHE BROSH  PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist6301013637MI

General Provider Information

NPI Number : 1417289125
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHAI MOSHE BROSH PHD
Provider Business Mailing Address
First Line : 1000 HOUGHTON AVE
Second Line :
City : SAGINAW
State : MI
Zip : 48602-5303
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3201 HALLMARK CT
Second Line :
City : SAGINAW
State : MI
Zip : 48603-2109
Country : US
Telephone Number : 989-790-5990
Fax Number : 989-746-7658
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2010
Last Update Date : 10/16/2023

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Directions to “ DR. SHAI MOSHE BROSH PHD” Practice Location

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