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Individual

DR. KATHREN HISHAM SHANGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
44428 WOODWARD AVE STE 102, PONTIAC, MI 48341-5009
(248) 858-3126
(248) 858-6499
Mailing address
24 FRANK LLOYD WRIGHT DR # J2000, ANN ARBOR, MI 48105-9484
(734) 747-6766
(734) 222-3100

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301512608
MI
390200000X
Student in an Organized Health Care Education/Training Program
4351048387
MI

Other

Enumeration date
06/14/2021
Last updated
07/23/2024
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