Provider Demographics
NPI:1023502218
Name:SHAHED, ARPON (DO)
Entity type:Individual
Prefix:
First Name:ARPON
Middle Name:
Last Name:SHAHED
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19959 VERNIER RD STE 400
Mailing Address - Street 2:
Mailing Address - City:HARPER WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48225-1423
Mailing Address - Country:US
Mailing Address - Phone:313-499-1951
Mailing Address - Fax:313-496-3934
Practice Address - Street 1:19959 VERNIER RD STE 400
Practice Address - Street 2:
Practice Address - City:HARPER WOODS
Practice Address - State:MI
Practice Address - Zip Code:48225-1423
Practice Address - Country:US
Practice Address - Phone:313-499-1951
Practice Address - Fax:313-496-3934
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-20
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI390200000X
MI5101026176207Q00000X
MI5101023925390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program