Healthcare Provider Details
I. General information
NPI: 1801844683
Provider Name (Legal Business Name): SHIFA HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/04/2006
Last Update Date: 10/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
44968 FORD RD SUITE G
CANTON MI
48187-5085
US
IV. Provider business mailing address
44968 FORD RD SUITE G
CANTON MI
48187-5085
US
V. Phone/Fax
- Phone: 734-927-6950
- Fax: 734-927-6954
- Phone: 734-927-6950
- Fax: 734-927-6954
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QS1200X |
| Taxonomy | Sleep Disorder Diagnostic Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
KAFEEL
KHAN
Title or Position: PRESIDENT
Credential:
Phone: 248-470-5282