Provider Demographics
NPI:1558457994
Name:SHINA, CHRISTINE S (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:S
Last Name:SHINA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25500 MEADOWBROOK RD STE 250
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1883
Mailing Address - Country:US
Mailing Address - Phone:248-277-3110
Mailing Address - Fax:
Practice Address - Street 1:25500 MEADOWBROOK RD STE 250
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1883
Practice Address - Country:US
Practice Address - Phone:248-277-3110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301080633207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI493615410Medicaid
CS080633OtherCHAMPUS-CHAMPUS
700H262220OtherBLUE CROSS-BLUE CROSS
CS080633OtherCOMMERCIAL-COMMERCIAL NUMBER
CS080633OtherCHAMPUS-CHAMPUS
I62273Medicare UPIN