Healthcare Provider Details

I. General information

NPI: 1245168848
Provider Name (Legal Business Name): SHEIGO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15801 PROVIDENCE DR APT 12F
SOUTHFIELD MI
48075-3138
US

IV. Provider business mailing address

15801 PROVIDENCE DR APT 12F
SOUTHFIELD MI
48075-3138
US

V. Phone/Fax

Practice location:
  • Phone: 313-319-4390
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MAISHA WIGGINS
Title or Position: CRANIAL PROSTHESIS MAKER
Credential:
Phone: 313-319-4390