Healthcare Provider Details

I. General information

NPI: 1427861350
Provider Name (Legal Business Name): HAVEN MEDICAL ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2025
Last Update Date: 11/25/2025
Certification Date: 11/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5151 GATEWAY CTR STE 400
FLINT MI
48507-3929
US

IV. Provider business mailing address

5151 GATEWAY CTR STE 400
FLINT MI
48507-3929
US

V. Phone/Fax

Practice location:
  • Phone: 810-230-4532
  • Fax: 810-963-2873
Mailing address:
  • Phone: 810-230-4532
  • Fax: 810-963-2873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHAHEEN LAKHAN
Title or Position: OWNER
Credential:
Phone: 818-574-3062