Individual
SHOUQ KHERALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2800 W GRAND BLVD, DETROIT, MI 48202-2610
(888) 245-6424
Mailing address
1 FORD PL STE 3A, DETROIT, MI 48202-3450
(313) 874-4806
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301513934
MI
207RH0000X
Hematology (Internal Medicine) Physician
4301513934
MI
207RX0202X
Medical Oncology Physician
Primary
4301513934
MI
Other
Enumeration date
06/30/2019
Last updated
07/21/2025
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