Healthcare Provider Details

I. General information

NPI: 1245193895
Provider Name (Legal Business Name): S.MEGALA, MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5105 W BRISTOL RD
FLINT MI
48507-2955
US

IV. Provider business mailing address

5105 W BRISTOL RD
FLINT MI
48507-2955
US

V. Phone/Fax

Practice location:
  • Phone: 810-733-0822
  • Fax: 810-733-5567
Mailing address:
  • Phone: 810-733-0822
  • Fax: 810-733-5567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SHADY MEGALA
Title or Position: MEMBER PHYSICIAN
Credential: MD
Phone: 810-813-6968