Provider Demographics
NPI:1306397518
Name:AMRO SHETA PLLC
Entity Type:Organization
Organization Name:AMRO SHETA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMRO
Authorized Official - Middle Name:R
Authorized Official - Last Name:SHETA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:517-525-8565
Mailing Address - Street 1:2043 MAPLERIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-2750
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2043 MAPLERIDGE RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-2750
Practice Address - Country:US
Practice Address - Phone:517-525-8565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN95590020Medicare PIN