Healthcare Provider Details

I. General information

NPI: 1750545828
Provider Name (Legal Business Name): MOHD SHAFFI KANJWAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2008
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44344 DEQUINDRE RD ST 360
STERLING HEIGHTS MI
48314
US

IV. Provider business mailing address

44344 DEQUINDRE RD ST 360
STERLING HEIGHTS MI
48314
US

V. Phone/Fax

Practice location:
  • Phone: 586-254-0707
  • Fax: 586-254-7207
Mailing address:
  • Phone: 586-254-0707
  • Fax: 586-254-7207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number4301100427
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number4301100427
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number4301100427
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: