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General NPI Number Information
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NPI Number | 1982991667
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Entity Type | Individual
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Provider Name | MOHANAD SHAAR M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/01/2011
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 3990 JOHN R ST
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City | DETROIT
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State | MI
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Zip | 48201-2018
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Country | US
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Telephone | 313-745-8555
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Fax |
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Provider Business Mailing Address
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Address Line | 400 MACK AVE
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City | DETROIT
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State | MI
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Zip | 48201-2136
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Country | US
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Telephone | 313-448-9006
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | MD2021-0116
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 270985
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 036147816
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | ECM0003115
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License Number State | MI
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