Provider Demographics
NPI:1801844683
Name:SHIFA HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:SHIFA HEALTHCARE SERVICES, LLC
Other - Org Name:GREAT LAKES SLEEP DIAGNOSTICS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:KAFEEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-470-5282
Mailing Address - Street 1:44968 FORD RD
Mailing Address - Street 2:SUITE G
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-5085
Mailing Address - Country:US
Mailing Address - Phone:734-927-6950
Mailing Address - Fax:734-927-6954
Practice Address - Street 1:44968 FORD RD
Practice Address - Street 2:SUITE G
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-5085
Practice Address - Country:US
Practice Address - Phone:734-927-6950
Practice Address - Fax:734-927-6954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P42780Medicare PIN
MI0P44240Medicare PIN