Provider Demographics
NPI:1750816799
Name:SHAKAROUN, DANIA ALI (MD)
Entity type:Individual
Prefix:DR
First Name:DANIA
Middle Name:ALI
Last Name:SHAKAROUN
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 1:24555 HAIG ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-3322
Mailing Address - Country:US
Mailing Address - Phone:313-375-2000
Mailing Address - Fax:
Practice Address - Street 1:24555 HAIG ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-3322
Practice Address - Country:US
Practice Address - Phone:313-375-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2024-06-19
Deactivation Date:2017-11-29
Deactivation Code:
Reactivation Date:2017-12-16
Provider Licenses
StateLicense IDTaxonomies
MI4301509926207RC0200X, 207RS0012X
MI4301112983207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine