MEDICARE: DR. SAMER M SHOUKFEH

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	1223G0001X	General Practice Dentistry	2901018470	MI
2	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2901018470	OTHER	MI	STATE LICENSE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619006509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMER M SHOUKFEH

Provider Business Mailing Address
First Line	:	42448 CHERRY HILL RD STE 100
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-3693
Country	:	US
Telephone Number	:	248-761-5821
Fax Number	:

Provider Business Practice Location Address
First Line	:	42448 CHERRY HILL RD STE 100
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-3693
Country	:	US
Telephone Number	:	248-761-5821
Fax Number	:

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

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	03/13/2026

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