Organization

Kenneth W. Shaheen, M.D.,p.C.

Specialist in Troy, MI(View on Map)

Legal Business Name

Kenneth W. Shaheen, M.D.,p.C.

NPI Number

1093987927

NPI Type

Organization

Enumeration Date

04/01/2008

Specialties

(Taxonomies)

Code

174400000X

Primary Taxonomy

Yes

Licenses

State

Michigan

License Number

KS048031

Contact
Information

Purpose

Mailing
Location

Address

2585 CROOKS RD
2585 CROOKS RD

City

Troy
Troy

State

MI
MI

Postal Code

48084-4702
48084-4702

Country

US
US

Telephone Number

(248) 283-1110
(248) 283-1110

Authorized Official

Name

Mrs. Michelle Porter

Title or Position

MEDICAL BILLER

Telephone Number

(248) 283-1110

Identifiers

Identifier

2406317142

Identifier State

MI

Identifier Issuer

BCBS OF MICHIGAN

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 04/01/2008

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