Provider Demographics
NPI:1982826707
Name:RAY, SHEILA MAKIM (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEILA
Middle Name:MAKIM
Last Name:RAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13136 FORT ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-1102
Mailing Address - Country:US
Mailing Address - Phone:734-284-7223
Mailing Address - Fax:734-284-9580
Practice Address - Street 1:13136 FORT ST
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-1102
Practice Address - Country:US
Practice Address - Phone:734-284-7223
Practice Address - Fax:734-284-9580
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301051263207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0821469OtherBCBS
MI0821469OtherBCBS
MIF39393Medicare UPIN