Healthcare Provider Details

I. General information

NPI: 1568383032
Provider Name (Legal Business Name): ONDEMAND HEALTH AND WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1890 S PENNFIELD LN
CANTON MI
48188-2559
US

IV. Provider business mailing address

1890 S PENNFIELD LN
CANTON MI
48188-2559
US

V. Phone/Fax

Practice location:
  • Phone: 248-842-1311
  • Fax:
Mailing address:
  • Phone: 248-842-1311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: FURHA IMAN SHUTTARI
Title or Position: NURSE PRACTITIONER
Credential: NP
Phone: 248-842-1311