Individual
DR. WILLIAM ABRAHAM SHAHEEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
10531 W JEFFERSON AVE, RIVER ROUGE, MI 48218-1306
(313) 841-5060
Mailing address
8598 LAKE RD, GROSSE ILE, MI 48138-1957
(734) 675-2079
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003733
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3475571
—
MI
01
—
5287400001
MEDICARE DME NO.
—
01
—
900H202090
BLUE CROSS PROVIDER NO.
MI
Enumeration date
05/14/2007
Last updated
03/22/2021
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