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NPI Code Detail

MEDICARE: MS. SHATHA ALKATIB MS, PA-C, MPH

MEDICARE: MS. SHATHA ALKATIB MS, PA-C, MPH
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
1363A00000XPhysician Assistant5601007139MI

General Provider Information

NPI Number : 1376948919
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHATHA ALKATIB MS, PA-C, MPH
Provider Business Mailing Address
First Line : 1560 E MAPLE RD
Second Line : SUITE 400-CREDENTIALING DEPT
City : TROY
State : MI
Zip : 48083-1138
Country : US
Telephone Number : 313-993-3434
Fax Number : 313-993-3421
Provider Business Practice Location Address
First Line : 34290 FORD RD
Second Line :
City : WESTLAND
State : MI
Zip : 48185-3051
Country : US
Telephone Number : 313-729-3643
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2014
Last Update Date : 03/05/2024

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