Shanidze, Irina Omarievna

Shanidze, Irina Omarievna is an individual health care provider with primary practice located at 29275 W 10 Mile Rd , Farmington Hills MI 48336-2817. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Pulmonary Disease is her primary health care specialty. Shanidze, Irina Omarievna can be contacted via phone (248) 350-2722.

Contact Information

Primary practice address
29275 W 10 Mile Rd Farmington Hills MI 48336-2817
Phone: (248) 350-2722
Fax: (248) 350-0154
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Critical Care Medicine 207RC0200X 4301078150 Michigan
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 4301078150 Michigan

Profile Details

NPI number 1518977198
LBN Legal business name Shanidze, Irina Omarievna
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2006
Last updated Dec 14th, 2011 - about 13 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 1518977198 NPPES
Michigan Other 0F37521 BLUE CROSS BLUE SHIELD
Michigan MEDICAID 1518977198 BLUE CROSS BLUE SHIELD

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