| NPI | 1841249760 |
|---|---|
| Former Legal Business Name | T.O. SHANAVAS, MD PC |
| Entity Type | Organization |
| Authorized Contact | ABDASSALAM HAJYOUSEF President 517-263-6733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2012-12-11 |