Provider Demographics
NPI:1497710982
Name:MARALANI, SHIVA J (MD)
Entity Type:Individual
Prefix:
First Name:SHIVA
Middle Name:J
Last Name:MARALANI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:20952 E 12 MILE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ST CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-3200
Mailing Address - Country:US
Mailing Address - Phone:586-771-4820
Mailing Address - Fax:586-771-6620
Practice Address - Street 1:20952 E 12 MILE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:ST CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-3200
Practice Address - Country:US
Practice Address - Phone:586-771-4820
Practice Address - Fax:586-771-6620
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2024-02-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010603682088F0040X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No2088F0040XAllopathic & Osteopathic PhysiciansUrologyFemale Pelvic Medicine and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI7738350002OtherCIGNA
MI01004182OtherHEALTH PLUS
MIG78723OtherHAP
MI340014930OtherRAILROAD MEDICARE
MI124503OtherPRIORITY HEALTH
MI5124630OtherAETNA
MI0219690001Medicare NSC
MI5124630OtherAETNA
MI340014930OtherRAILROAD MEDICARE