Provider Demographics
NPI:1316037757
Name:SHAH, VINAY NIRANJAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:VINAY
Middle Name:NIRANJAN
Last Name:SHAH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2950 HUNLEY DR
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-2690
Mailing Address - Country:US
Mailing Address - Phone:734-369-3539
Mailing Address - Fax:313-386-7979
Practice Address - Street 1:7125 ALLEN RD
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2009
Practice Address - Country:US
Practice Address - Phone:313-386-2273
Practice Address - Fax:313-386-7979
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302031753183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist