Basic Information
| Provider Information | |||||||||
| NPI: | 1023265014 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | RAHEEM | ||||||||
| FirstName: | SHAHEENA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 28411 NORTHWESTERN HWY | ||||||||
| Address2: | SUITE 1050 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480345544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483544709 | ||||||||
| FaxNumber: | 2483544807 | ||||||||
| Practice Location | |||||||||
| Address1: | 4201 SAINT ANTOINE ST STE 6A | ||||||||
| Address2: | |||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 482012153 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3137454627 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2008 | ||||||||
| LastUpdateDate: | 10/22/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 5101017985 | MI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 5315057639 | MI | N | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.