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NPI Code Detail

MEDICARE: KINJEL SHASTRI D.O

MEDICARE: KINJEL SHASTRI D.O
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207R00000XInternal Medicine Physician5101022537MI

General Provider Information

NPI Number : 1568810091
Entity Type Code : Individual
Provider Name (Legal Business Name) : KINJEL SHASTRI D.O
Provider Business Mailing Address
First Line : 5280 METROPOLITAN PKWY
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-4005
Country : US
Telephone Number : 248-290-3111
Fax Number :
Provider Business Practice Location Address
First Line : 5280 METROPOLITAN PKWY
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-4005
Country : US
Telephone Number : 248-290-3111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2016
Last Update Date : 06/29/2021

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Directions to “ KINJEL SHASTRI D.O” Practice Location

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