Jamoua, Diane Shahara
Jamoua, Diane Shahara is an sole proprietor health care provider with primary practice located at 4555 Wilson Ave Sw , Grandville MI 49418-2370. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Jamoua, Diane Shahara can be contacted via phone (616) 249-8490.Contact Information
Primary practice address
4555 Wilson Ave Sw
Grandville MI 49418-2370
Phone: (616) 249-8490
Fax: (616) 249-3129
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4901004760 | Michigan |
Profile Details
| NPI number | 1740620376 |
|---|---|
| LBN Legal business name | Jamoua, Diane Shahara |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 27th, 2013 |
| Last updated | Apr 27th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740620376 | NPPES |
| Michigan | MEDICAID | 1740620376 |
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