Provider Demographics
NPI:1659524429
Name:SHAIKH, RUBINA
Entity Type:Individual
Prefix:
First Name:RUBINA
Middle Name:
Last Name:SHAIKH
Suffix:
Gender:F
Credentials:
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 67000
Mailing Address - Street 2:DEPT 272801
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48267-2728
Mailing Address - Country:US
Mailing Address - Phone:517-841-7490
Mailing Address - Fax:517-841-6917
Practice Address - Street 1:4304 PAGE AVE
Practice Address - Street 2:
Practice Address - City:MICHIGAN CENTER
Practice Address - State:MI
Practice Address - Zip Code:49254-1078
Practice Address - Country:US
Practice Address - Phone:517-817-7582
Practice Address - Fax:517-817-7583
Is Sole Proprietor?:No
Enumeration Date:2008-10-24
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301090621207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine