Shammout, Brad A

Shammout, Brad A is an individual health care provider with primary practice located at 36175 Harper Ave , Clinton Township MI 48035-3274. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Shammout, Brad A can be contacted via phone (586) 741-3772.

Contact Information

Primary practice address
36175 Harper Ave Clinton Township MI 48035-3274
Phone: (586) 741-3772
Fax: (586) 741-4604
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 5101014470 Michigan

Profile Details

NPI number 1720067895
LBN Legal business name Shammout, Brad A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2006
Last updated Apr 20th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720067895 NPPES
Michigan Other 0Q26008 BCBS PROVIDER NUMBER
Michigan MEDICAID 4427962 BCBS PROVIDER NUMBER
Michigan Other 0H26188 BCBS PROVIDER NUMBER

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