Individual
GINO SHWKAT ETTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
27351 DEQUINDRE RD, MADISON HEIGHTS, MI 48071-3487
(248) 967-7661
(248) 967-7876
Mailing address
27351 DEQUINDRE RD, MADISON HEIGHTS, MI 48071-3487
(248) 967-7661
(248) 967-7876
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35.141973
OH
207P00000X
Emergency Medicine Physician
4301501047
MI
Other
Enumeration date
05/24/2018
Last updated
11/04/2021
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