Provider Demographics
NPI:1104284009
Name:SHAHEEN, MICHAEL D (DC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:D
Last Name:SHAHEEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 E SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-2740
Mailing Address - Country:US
Mailing Address - Phone:517-337-3080
Mailing Address - Fax:517-337-3082
Practice Address - Street 1:250 E SAGINAW ST
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-2740
Practice Address - Country:US
Practice Address - Phone:517-337-3080
Practice Address - Fax:517-337-3082
Is Sole Proprietor?:No
Enumeration Date:2016-02-05
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301010388111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation