Organization Active NPI

Shawqi E Halabu M.D. PC

  • Specialist
  • Farmington, MI
National Provider Identifier
1821312380
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
SHO42299 Issued in MI
Legal business name
SHAWQI E HALABU M.D. PC
Practice address
23133 Orchard Lake Rd Ste 204
Farmington, MI 48336-3279
Phone
(248) 615-2020
Fax
(248) 615-4055
NPI assigned
Mar 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Authorized official

Name
Dr. Shawqi E Halabu, M.D.NPI 1861573610
Title
President
Phone
(248) 615-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X SHO42299 MI Primary

Addresses

Primary practice location

23133 Orchard Lake Rd Ste 204
Farmington, MI 48336-3279

Mailing address

23133 Orchard Lake Rd Ste 204
Farmington, MI 48336-3279
Phone (248) 615-2020

Other identifiers 2

IdentifierTypeStateIssuer
60F390260OtherMIBLUE CROSS BLUE SHIELD OF MICHIGAN
0F39026OtherMIBLUE CROSS BLUE SHIELD OF MICHIGAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100715000392 MI Part B Supplier - Clinic/Group Practice 5698807378 Receives reassigned benefits from 1 practitioner
Practice locations: Birmingham, MI; Farmington, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1269561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573689600000",
    "number": "1821312380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23133 ORCHARD LAKE RD STE 204",
            "city": "FARMINGTON",
            "state": "MI",
            "postal_code": "483363279",
            "telephone_number": "248-615-2020",
            "fax_number": "248-615-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23133 ORCHARD LAKE RD STE 204",
            "city": "FARMINGTON",
            "state": "MI",
            "postal_code": "483363279",
            "telephone_number": "248-615-2020",
            "fax_number": "248-615-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHAWQI E HALABU M.D. PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-26",
        "last_updated": "2019-11-14",
        "status": "A",
        "authorized_official_last_name": "HALABU",
        "authorized_official_first_name": "SHAWQI",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-615-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MI",
            "license": "SHO42299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "60F390260",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "0F39026",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2019; 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.