Mark Wayne Shatz, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

6301005043 Issued in MI

Practice address

33505 W 14 Mile Rd
Suite 70
Farmington Hills, MI 48331-1588

Phone

(248) 661-3300

Fax

(248) 661-9209

NPI assigned

May 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912116179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33505 W 14 MILE RD",
            "address_2": "SUITE 70",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483311588",
            "telephone_number": "248-661-3300",
            "fax_number": "248-661-9209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33505 W 14 MILE RD",
            "address_2": "SUITE 70",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483311588",
            "telephone_number": "248-661-3300",
            "fax_number": "248-661-9209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHATZ",
        "first_name": "MARK",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MI",
            "license": "6301005043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvette Sharpley
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• Harley Sharrock
• Denise Sharski
• Madison Shashaguay
• Helene Shavell, M.S.W.
• Bailey Shaver
• Katlyn Shaver
• Noella Shaver
• Kelia Shavers

• Clinical Neuropsychologist in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Clinical Neuropsychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.