Provider Demographics
NPI:1962974253
Name:JONNA, SHAHAD RAAD (PA-C)
Entity type:Individual
Prefix:
First Name:SHAHAD
Middle Name:RAAD
Last Name:JONNA
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:6450 FARMINGTON RD STE 115
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4456
Mailing Address - Country:US
Mailing Address - Phone:734-331-6037
Mailing Address - Fax:
Practice Address - Street 1:6450 FARMINGTON RD STE 115
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4456
Practice Address - Country:US
Practice Address - Phone:734-331-6037
Practice Address - Fax:734-331-6260
Is Sole Proprietor?:No
Enumeration Date:2018-12-26
Last Update Date:2021-10-27
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant