Individual provider Active NPI

Shukri Dualeh, MD

  • Student in an Organized Health Care Education/Training Program
  • Ann Arbor, MI
National Provider Identifier
1467015255
Registry record updated Apr 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
4351044082 Issued in MI
Practice address
1500 E Medical Center Drive
Taubman Center 2ND Floor, Reception F
Ann Arbor, MI 48109-5332
Phone
(734) 936-6927
NPI assigned
Apr 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 4351044082 MI Primary

Addresses

Primary practice location

1500 E Medical Center Drive
Taubman Center 2ND Floor, Reception F
Ann Arbor, MI 48109-5332

Mailing address

1500 E Medical Center Drive
2920 TC
Ann Arbor, MI 48109-5331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190506000631 MI Order and Referring Only - General SurgeryPractitioner - General Surgery 8820330202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1555459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555459200000",
    "number": "1467015255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DRIVE",
            "address_2": "2920 TC",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DRIVE",
            "address_2": "TAUBMAN CENTER 2ND FLOOR, RECEPTION F",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095332",
            "telephone_number": "734-936-6927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUALEH",
        "first_name": "SHUKRI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-17",
        "last_updated": "2019-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4351044082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.