Organization Active NPI

Shamael Haque, D.O., PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Canton, MI
National Provider Identifier
1265295653
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SHAMAEL HAQUE, D.O., PLLC
Practice address
44245 Ford Rd Ste 101
Canton, MI 48187-3163
Phone
(248) 977-7247
Fax
(248) 971-2020
NPI assigned
Jan 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Shahid Syed
Title
Manager
Phone
(248) 703-3556

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

44245 Ford Rd Ste 101
Canton, MI 48187-3163

Mailing address

44245 Ford Rd Ste 101
Canton, MI 48187-3163
Phone (248) 977-7247

Other names 1

  • Midwest Mind Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240604003566 MI Part B Supplier - Clinic/Group Practice 3274075379 Receives reassigned benefits from 4 practitioners
Practice locations: Canton, MI; Dearborn Heights, MI

National Provider Directory

National Provider Directory

Locations

2510 S Telegraph Rd
Ste L247
Bloomfield Township, MI 48302

44245 Ford Rd
Ste 101
Canton, MI 48187
Phone (248) 977-7247

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1265295653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44245 FORD RD STE 101",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873163",
            "telephone_number": "248-977-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44245 FORD RD STE 101",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481873163",
            "telephone_number": "248-977-7247",
            "fax_number": "248-971-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAMAEL HAQUE, D.O., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-30",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "SYED",
        "authorized_official_first_name": "SHAHID",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "248-703-3556"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Mind Associates",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Midwest Mind Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.