Organization
MADISON INTERNISTS P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAKEELA SHAKOOR M.D (OWNER)
(248) 797-9063
Entity
Organization
Contact information
Practice address
27483 DEQUINDRE RD, SUITE 202, MADISON HTS, MI 48071-3491
(248) 542-2229
(248) 542-2226
Mailing address
3120 CARPENTER ST, SUITE 209, HAMTRAMCK, MI 48212-9802
(313) 891-5437
(313) 891-0842
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
4301078037
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4998578
—
MI
Enumeration date
09/25/2007
Last updated
09/25/2007
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