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NPI Code Detail

MEDICARE: FARYAL SHAHEEN

MEDICARE: FARYAL SHAHEEN
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
1225X00000XOccupational Therapist5201009711MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184281610
Entity Type Code : Individual
Provider Name (Legal Business Name) : FARYAL SHAHEEN
Provider Business Mailing Address
First Line : 9500 GRAND RIVER AVE
Second Line :
City : DETROIT
State : MI
Zip : 48204-2132
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9500 GRAND RIVER AVE
Second Line :
City : DETROIT
State : MI
Zip : 48204-2132
Country : US
Telephone Number : 313-491-7920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2019
Last Update Date : 05/21/2019

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Directions to “ FARYAL SHAHEEN ” Practice Location

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