Doctor Name: | DR. RAAFAT BOLES MAHROUS SHEHATA |
NPI Number: | 1891078846 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 4301099522 |
Business Practice Address: | 500 Kirts Blvd Suite 200 Troy, MI - 480844134 |
Business Phone Number: | 2488246060 |
Business Fax Number: | 2486860772 |
Mailing Address: | Po Box 1239, TROY |
State: | MI |
Postal Code: | 480991239 |
Phone Number: | 2488246060 |
Fax Number: | 2486860772 |
NPI Enumeration Date: | 09/26/2011 |
NPI Last Update Date: | 04/04/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 4301099522 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |