MEDICARE: DR. CHRISTINA LYNN SHABET MD

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	390200000X	Student in an Organized Health Care Education/Training Program	4351052205	MI

General Provider Information

NPI Number	:	1447956354
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTINA LYNN SHABET MD

Provider Business Mailing Address
First Line	:	1500 E MEDICAL CENTER DRIVE
Second Line	:	2130 TAUBMAN CENTER, SPC 5340
City	:	ANN ARBOR
State	:	MI
Zip	:	48109-5340
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 E MEDICAL CENTER DR
Second Line	:	2130 TAUBMAN CENTER, SPC 5340
City	:	ANN ARBOR
State	:	MI
Zip	:	48109-5340
Country	:	US
Telephone Number	:	734-936-5895
Fax Number	:

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

Provider Enumeration Date	:	02/02/2023
Last Update Date	:	04/13/2024

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