Provider Demographics
NPI:1457409088
Name:SHIENER, GERALD ALAN (M D)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:ALAN
Last Name:SHIENER
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 E MERRILL ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-6121
Mailing Address - Country:US
Mailing Address - Phone:248-645-5155
Mailing Address - Fax:248-645-2665
Practice Address - Street 1:251 E MERRILL ST
Practice Address - Street 2:SUITE 230
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6121
Practice Address - Country:US
Practice Address - Phone:248-645-5155
Practice Address - Fax:248-645-2665
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIGS0365632084F0202X, 2084P0800X, 2084P0802X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
Not Answered2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2091739Medicaid
MI2091739Medicaid
MI06316657261Medicare ID - Type Unspecified