Individual
DR. SHADY S SHEBAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3815 PELHAM ST STE 13, DEARBORN, MI 48124-3852
(131) 368-0080
(313) 241-9342
Mailing address
3815 PELHAM ST STE 13, DEARBORN, MI 48124-3852
(131) 368-0080
(313) 241-9342
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
4301110580
MI
2084P0800X
Psychiatry Physician
Primary
4301110580
MI
2084P0804X
Child & Adolescent Psychiatry Physician
4301110580
MI
2084P0804X
Child & Adolescent Psychiatry Physician
99999
MI
390200000X
Student in an Organized Health Care Education/Training Program
4301110580
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
831910484
—
MI
Enumeration date
06/06/2013
Last updated
08/01/2025
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