Nathan Stepanek Shaller, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

20107-01787 Issued in NC

Practice address

1301 Catherine Street
Ann Arbor, MI 48109-5602

Phone

(734) 764-3270

Fax

(734) 615-2964

NPI assigned

Jul 18, 2012

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527120000000",
    "number": "1306191085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-2255",
            "fax_number": "336-716-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 CATHERINE STREET",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095602",
            "telephone_number": "734-764-3270",
            "fax_number": "734-615-2964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALLER",
        "first_name": "NATHAN",
        "middle_name": "STEPANEK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-18",
        "last_updated": "2018-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NC",
            "license": "20107-01787",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301101669",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Vikram Govindaraju Shakkottai, M.D.
• Laurie Marie Shamamy, LMSW
• Sabina Shamayeva, MD
• Qurratul Aine Shamim-Uzzaman, MD
• Carmen Marie Shammami
• Kimberly Lauren Shampain, MD

• Anatomic Pathology & Clinical Pathology Physician in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Anatomic Pathology & Clinical Pathology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.