Wadie Shukri David, DO

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

5101027898 Issued in MI

Practice address

22250 Providence Dr Ste 705
Southfield, MI 48075-6215

Phone

(248) 552-9858

Fax

(248) 849-9510

NPI assigned

Mar 29, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Interoperability endpoints

• Direct secure messaging: wdavid1040490@direct.trinity-health.org

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

{
    "created_epoch": "1616976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1740868272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 705",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756215",
            "telephone_number": "248-552-9858",
            "fax_number": "248-849-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR STE 705",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480756215",
            "telephone_number": "248-552-9858",
            "fax_number": "248-849-9510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5301 McAuley Dr",
            "address_purpose": "LOCATION",
            "city": "Ypsilanti",
            "state": "MI",
            "postal_code": "481971051",
            "country_code": "US",
            "telephone_number": "248-930-8234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVID",
        "first_name": "WADIE",
        "middle_name": "SHUKRI",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-29",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "5101027898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Ypsilanti",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5301 McAuley Dr",
            "city": "Ypsilanti",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481971051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David M Kirschner DDS PC
• David N Mittelman PHD LLC
• Amelia David
• Geula David
• Shukri Wadi David, MD
• Abigail L Davidson
• Claire Davidson
• Marvin Henry Davidson, LMSW
• Portteia Xaraiya Saahdjai Davidson
• Kaitlyn Davies, RN

• Cardiovascular Disease Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Cardiovascular Disease Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.