Provider Demographics
NPI:1194717280
Name:TINKELMAN, SHELI L (PA-C)
Entity type:Individual
Prefix:MS
First Name:SHELI
Middle Name:L
Last Name:TINKELMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31420 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 150
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48334-2508
Mailing Address - Country:US
Mailing Address - Phone:248-538-0109
Mailing Address - Fax:248-538-0675
Practice Address - Street 1:197 LOUDON RD STE 350
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:978-691-5690
Practice Address - Fax:978-691-5693
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2018-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601003149363A00000X
NH1351363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH1351OtherSTATE LICENSE
MI070F358740OtherBCBSM
MIP06952Medicare UPIN