Healthcare Provider Details

I. General information

NPI: 1245397348
Provider Name (Legal Business Name): SAFAA SHAKIK HAKIM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. SAFAA SHAKIK REZUALLA

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 SNOWMASS DR
ROCHESTER HILLS MI
48309-1322
US

IV. Provider business mailing address

640 SNOWMASS DR
ROCHESTER HILLS MI
48309-1322
US

V. Phone/Fax

Practice location:
  • Phone: 860-886-9114
  • Fax: 248-659-8032
Mailing address:
  • Phone: 860-886-9114
  • Fax: 248-659-8032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number028583
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number028538
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: