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NPI Code Detail

MEDICARE: THOMAS M SHEHAB M.D.

MEDICARE:   THOMAS M SHEHAB  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician065691MI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
6110239995OTHERMIMEDICARE RAILROAD PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1023609OTHERMIMIDWEST HEALTH PLAN
23949257OTHERMICIGNA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
428223OTHERMIAETNA
50812248OTHERMIBCBS INDIVIDUAL
70H14989OTHERMIBCBS GROUP

General Provider Information

NPI Number : 1114906559
Entity Type Code : Individual
Provider Name (Legal Business Name) : THOMAS M SHEHAB M.D.
Provider Business Mailing Address
First Line : 5300 ELLIOTT DR
Second Line :
City : YPSILANTI
State : MI
Zip : 48197-8632
Country : US
Telephone Number : 734-434-6262
Fax Number : 734-712-2820
Provider Business Practice Location Address
First Line : 5300 ELLIOTT DR
Second Line :
City : YPSILANTI
State : MI
Zip : 48197-8632
Country : US
Telephone Number : 734-434-6262
Fax Number : 734-712-2820
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/13/2006
Last Update Date : 01/14/2010

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Directions to “ THOMAS M SHEHAB M.D.” Practice Location

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