MEDICARE: DR. MITCHELL S SHEK MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	4301407365	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	070008143	OTHER	MI	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235129982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MITCHELL S SHEK MD

Provider Business Mailing Address
First Line	:	800 S ADAMS RD
Second Line	:	SUITE 101
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-7005
Country	:	US
Telephone Number	:	248-646-9597
Fax Number	:	248-646-4067

Provider Business Practice Location Address
First Line	:	800 S ADAMS RD
Second Line	:	SUITE 101
City	:	BIRMINGHAM
State	:	MI
Zip	:	48009-7005
Country	:	US
Telephone Number	:	248-646-9597
Fax Number	:	248-646-4067

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	07/16/2010

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Directions to “ DR. MITCHELL S SHEK MD” Practice Location

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