Organization
KENNETH W. SHAHEEN, M.D.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MICHELLE MARIE PORTER (MEDICAL BILLER)
(248) 283-1110
Entity
Organization
Contact information
Practice address
2585 CROOKS RD, TROY, MI 48084-4702
(248) 283-1110
(248) 283-1114
Mailing address
2585 CROOKS RD, TROY, MI 48084-4702
(248) 283-1110
(248) 283-1114
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
KS048031
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2406317142
BCBS OF MICHIGAN
MI
Enumeration date
04/01/2008
Last updated
04/01/2008
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