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Individual

DR. KELLY SUSEWITZ SHAKOOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
9315 TELEGRAPH RD, REDFORD, MI 48239-1260
(313) 450-4500
Mailing address
4169 KINGSTON ST, DEARBORN HEIGHTS, MI 48125-3237
(734) 306-8586

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704239124
MI

Other

Enumeration date
09/18/2018
Last updated
08/06/2019
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