Shastry, Manjali Sushil

Shastry, Manjali Sushil is an sole proprietor health care provider with primary practice located at 1787 S M 52 , Owosso MI 48867-9201. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Shastry, Manjali Sushil can be contacted via phone (989) 729-4600.

Contact Information

Primary practice address
1787 S M 52 Owosso MI 48867-9201
Fax: (989) 725-5760
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 4301069446 Michigan

Profile Details

NPI number 1801990254
LBN Legal business name Shastry, Manjali Sushil
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 7th, 2006
Last updated Mar 26th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801990254 NPPES
Michigan MEDICAID 4552316

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