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NPI Code Detail

MEDICARE: SHEIRAZ TEKKO MSN, CPNP-PC

MEDICARE:   SHEIRAZ  TEKKO  MSN, CPNP-PC
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
1363LP0200XPediatric Nurse Practitioner4704276630MI

General Provider Information

NPI Number : 1548655046
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHEIRAZ TEKKO MSN, CPNP-PC
Provider Business Mailing Address
First Line : 1 FORD PL STE 3A
Second Line :
City : DETROIT
State : MI
Zip : 48202-3450
Country : US
Telephone Number : 800-999-5829
Fax Number : 313-876-1305
Provider Business Practice Location Address
First Line : 2251 ANTIETAM AVE
Second Line :
City : DETROIT
State : MI
Zip : 48207
Country : US
Telephone Number : 313-818-3654
Fax Number : 313-818-6385
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/01/2015
Last Update Date : 12/11/2025

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Directions to “ SHEIRAZ TEKKO MSN, CPNP-PC” Practice Location

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