Individual
MR. WADIE SHUKRI DAVID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
22250 PROVIDENCE DR STE 705, SOUTHFIELD, MI 48075-6215
(248) 552-9858
(248) 849-9510
Mailing address
22250 PROVIDENCE DR STE 705, SOUTHFIELD, MI 48075-6215
(248) 552-9858
(248) 849-9510
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
5101027898
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
MI
Other
Enumeration date
03/29/2021
Last updated
06/21/2024
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