MEDICARE: NARIMAN SHAMOON

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
1	305S00000X	Point of Service	0036565561	MI

General Provider Information

NPI Number	:	1740666098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NARIMAN SHAMOON

Provider Business Mailing Address
First Line	:	14585 SPARROW DR
Second Line	:
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48315-5042
Country	:	US
Telephone Number	:	586-822-7365
Fax Number	:

Provider Business Practice Location Address
First Line	:	14585 SPARROW DR
Second Line	:
City	:	SHELBY TOWNSHIP
State	:	MI
Zip	:	48315-5042
Country	:	US
Telephone Number	:	586-822-7365
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2015
Last Update Date	:	08/09/2015

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Directions to “ NARIMAN SHAMOON ” Practice Location

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