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General NPI Number Information
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NPI Number | 1801257738
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Entity Type | Organization
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Legal Business Name | ALSHEFA FAMILY PRACTICE PLLC
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Dates
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Enumeration Date | 03/20/2016
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Last Update Date | 03/20/2016
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Provider Practice Location Address
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Address Line | 28780 RYAN RD SUITE B
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City | WARREN
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State | MI
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Zip | 48092-2521
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Country | US
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Telephone | 586-261-6201
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Fax | 586-261-4830
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Provider Business Mailing Address
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Address Line | 28780 RYAN RD SUITE B
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City | WARREN
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State | MI
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Zip | 48092-2521
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Country | US
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Telephone | 586-261-6201
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Fax | 586-261-4830
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Authorized Official
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Title or Position | PHYSICIAN / OWNER
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Name | MERAJ YUNUS
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Credential | MD
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Telephone | 586-261-6201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 5101015182
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5101015182
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License Number State | MI
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