Provider Demographics
NPI:1467565440
Name:AL-SHEIKH, MAHER GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:MAHER
Middle Name:GEORGE
Last Name:AL-SHEIKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:MI
Mailing Address - Zip Code:48854-0010
Mailing Address - Country:US
Mailing Address - Phone:517-676-9788
Mailing Address - Fax:517-676-3438
Practice Address - Street 1:4780 OKEMOS RD
Practice Address - Street 2:SUITE 4
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-1669
Practice Address - Country:US
Practice Address - Phone:517-349-3210
Practice Address - Fax:517-349-7345
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301065921207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3516155 10Medicaid
MI3516155 10Medicaid
MI0M76080Medicare PIN