Provider Demographics
NPI:1205473097
Name:SHEENA, NAIL MICHAEL (RPH)
Entity type:Individual
Prefix:MR
First Name:NAIL
Middle Name:MICHAEL
Last Name:SHEENA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5850 LYNNE HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-1294
Mailing Address - Country:US
Mailing Address - Phone:248-630-6221
Mailing Address - Fax:248-693-3507
Practice Address - Street 1:460 N LAPEER RD
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48362-1581
Practice Address - Country:US
Practice Address - Phone:248-693-3284
Practice Address - Fax:248-693-3507
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-29
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302025456183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty