Healthcare Provider Details

I. General information

NPI: 1811849409
Provider Name (Legal Business Name): YAVAR SHAIKH
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1644 BRENTWOOD DR
TROY MI
48098-2706
US

IV. Provider business mailing address

1644 BRENTWOOD DR
TROY MI
48098-2706
US

V. Phone/Fax

Practice location:
  • Phone: 248-275-4526
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704420409
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: