Organization
KHALED M SHUKAIRY MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHALED M SHUKAIRY MD (PRESIDENT/OWNER)
(810) 742-0225
Entity
Organization
Contact information
Practice address
1501 S CENTER RD, BLDG B, BURTON, MI 48509-1731
(810) 742-0225
(810) 742-7990
Mailing address
1501 S CENTER RD, BLDG B, BURTON, MI 48509-1731
(810) 742-0225
(810) 742-7990
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
4301037118
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2126594
—
MI
Enumeration date
09/20/2007
Last updated
11/23/2009
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