Shebak, Shady S
Shebak, Shady S is an individual health care provider with primary practice located at 3815 Pelham St Ste 13 , Dearborn MI 48124-3852. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is his primary health care specialty. Shebak, Shady S can be contacted via phone (131) 368-0080.Contact Information
Primary practice address
3815 Pelham St Ste 13
Dearborn MI 48124-3852
Phone: (131) 368-0080
Fax: (313) 241-9342
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Addiction Medicine | 2084A0401X | 4301110580 | Michigan |
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 4301110580 | Michigan |
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 4301110580 | Michigan |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 4301110580 | Michigan |
| Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry | 2084P0804X | 99999 | Michigan |
Profile Details
| NPI number | 1629416169 |
|---|---|
| LBN Legal business name | Shebak, Shady S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2013 |
| Last updated | Aug 10th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629416169 | NPPES |
| Michigan | MEDICAID | 831910484 |
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