# KHALED M SHUKAIRY MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386830651
- **Authorized official:** KHALED M SHUKAIRY MD (PRESIDENT/OWNER)
- **Authorized official phone:** (810) 742-0225

## Contact information

- **Practice address:** 1501 S CENTER RD, BLDG B, BURTON, MI 48509-1731
- **Practice address phone:** (810) 742-0225
- **Practice address fax:** (810) 742-7990
- **Mailing address:** 1501 S CENTER RD, BLDG B, BURTON, MI 48509-1731
- **Mailing address phone:** (810) 742-0225
- **Mailing address fax:** (810) 742-7990

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | 4301037118 | MI | Yes |

## Other

- **Enumeration date:** 09/20/2007
- **Last updated:** 11/23/2009