Individual
DR. SHUJA HAQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4646 JOHN R STREET, 11MH, DETROIT, MI 48201-1916
(313) 576-3373
(313) 576-1091
Mailing address
4646 JOHN R ST, 11MH, DETROIT, MI 48201-1916
(313) 576-3373
(313) 576-1091
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301055826
MI
2084P0805X
Geriatric Psychiatry Physician
4301055826
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2606339032
BCBS
MI
05
—
4347496
—
MI
05
—
4369742
—
MI
Enumeration date
08/30/2006
Last updated
08/27/2024
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