Provider Demographics
NPI:1356978233
Name:SHAH, SHEENA PARESH (MD)
Entity type:Individual
Prefix:
First Name:SHEENA
Middle Name:PARESH
Last Name:SHAH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1860
Mailing Address - Fax:
Practice Address - Street 1:25631 LITTLE MACK AVE STE 103
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-2100
Practice Address - Country:US
Practice Address - Phone:586-443-2333
Practice Address - Fax:586-443-2332
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2023-09-18
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Provider Licenses
StateLicense IDTaxonomies
MI4301508964207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine