MEDICARE: DR. RONALD E SHAHEEN DO

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	5101008990	MI

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C2919	OTHER	MI	MCARE
2	E26685	OTHER	MI	HEALTH ALLIANCE PLAN
3	0152508425	OTHER	MI	BLUE CROSS BLUE SHIELD
4	080D410020	OTHER	MA	BLUE CARE NETWORK
5	4237665	OTHER	MI	AETNA
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	0089002500	OTHER	MI	HEALTH PLUS
8	204395	OTHER	MI	HEALTH ADVANTAGE NETWORK
9	204395	OTHER	MI	MCLAREN HEALTH PLAN
10	2938395001	OTHER	MI	CIGNA
11	080D410020	OTHER	MI	BLUE CROSS BLUE SHIELD
12	080095728/CD3616	OTHER	MI	METRAHEALTH
13	E26685	OTHER	MI	HEALTH NET FEDERAL

NPI Number	:	1154310621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD E SHAHEEN DO

Provider Business Mailing Address
First Line	:	401 S BALLENGER HWY
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48532-3638
Country	:	US
Telephone Number	:	810-342-1000
Fax Number	:	810-342-1590

Provider Business Practice Location Address
First Line	:	1314 S LINDEN RD
Second Line	:
City	:	FLINT
State	:	MI
Zip	:	48532-3456
Country	:	US
Telephone Number	:	810-342-1700
Fax Number	:	810-720-4035

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	09/30/2011

1314 S LINDEN RD STE A
FLINT, MI
48532-3456

Practice Phone: 810-342-1750
Practice Fax: