Provider Demographics
NPI:1922312487
Name:HARPER-SHANKIE, MEGHAN REGINA (MD)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:REGINA
Last Name:HARPER-SHANKIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:26901 BEAUMONT BLVD
Mailing Address - Street 2:STE 3D
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1864
Mailing Address - Fax:947-522-0307
Practice Address - Street 1:28595 ORCHARD LAKE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-2977
Practice Address - Country:US
Practice Address - Phone:248-553-0010
Practice Address - Fax:248-553-5957
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2020-03-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMT197524208000000X
MI43011040412080P0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental Disabilities
No208000000XAllopathic & Osteopathic PhysiciansPediatrics