NPI 1154148807

Shihata Nelson

Practitioner Driver Detroit, MI

Practice location

Address: 18630 Washburn St, Detroit, MI 48221-1916
Phone: (313) 231-0829
Fax: (313) 862-3288

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence 801265656 (MI)

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Registry record

NPI: 1154148807
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Sep 2024
Record last updated: 24 Sep 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.