Provider Demographics
NPI:1538401658
Name:GASSAN SHAHIN MD PC
Entity type:Organization
Organization Name:GASSAN SHAHIN MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GASSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-570-2392
Mailing Address - Street 1:27328 CLAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48127
Mailing Address - Country:US
Mailing Address - Phone:313-570-2392
Mailing Address - Fax:313-278-4266
Practice Address - Street 1:31471 NORTHWESTERN HWY
Practice Address - Street 2:SUITE # 3
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334
Practice Address - Country:US
Practice Address - Phone:313-570-2392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2013-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody ImagingGroup - Multi-Specialty
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Multi-Specialty