Healthcare Provider Details

I. General information

NPI: 1770544785
Provider Name (Legal Business Name): EMAD RAWHY SHEHADA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 07/20/2022
Certification Date: 07/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 BARCLAY CIR STE 205
ROCHESTER HILLS MI
48307-5821
US

IV. Provider business mailing address

75 BARCLAY CIR STE 205
ROCHESTER HILLS MI
48307-5821
US

V. Phone/Fax

Practice location:
  • Phone: 248-651-6430
  • Fax: 248-650-1382
Mailing address:
  • Phone: 248-651-6430
  • Fax: 248-650-1382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301079678
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number4301079678
License Number StateMI
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number4301079678
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: