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General NPI Number Information
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NPI Number | 1851752331
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Entity Type | Organization
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Legal Business Name | MERCY INTERNAL MEDICINE PLLC
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Dates
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Enumeration Date | 03/11/2016
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 16001 W 9 MILE RD
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4818
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Country | US
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Telephone | 586-214-4556
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Fax | 248-849-7448
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Provider Business Mailing Address
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Address Line | 42451 BEECHWOOD DR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48314-2943
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NABEEL SHABO
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Credential | MD
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Telephone | 586-214-4556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 4301089948
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License Number State | MI
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