CHRISTINA MUBARAK SHANTI (NPI# 1124015565) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124015565 |
| Entity Type | Individual |
| Full Name | CHRISTINA MUBARAK SHANTI |
| Credential | M.D. |
| Practice Address |
Henry Ford Health System 2799 West Grand Boulevard Detroit MI 48202 |
| Practice Telephone | 3139169106 |
| Practice Fax Number | 3139161249 |
| Mailing Telephone | 3139169106 |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2008-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
4301070255 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4735568 | 05 | |
| MI | 4735577 | 05 | |
| COMMERCIAL-COMMERCIAL NUMBER | CS070255 | 01 | |
| MI | GROUP NPI | 1396817714 | 01 |
| MI | 4864707 | 05 | |
| CHAMPUS-CHAMPUS | CS070255 | 01 |
| Street Address |
HENRY FORD HEALTH SYSTEM 2799 WEST GRAND BOULEVARD |
| City | DETROIT |
| State | MI |
| Zip Code | 48202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336147461 | Joseph Lawrence Lelli | Surgery | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2005-07-12 |
| 1053794859 | Ali Malik | Podiatrist | Henry Ford Health System, 1 Ford Pl Ste 2e, Detroit, MI 48202 | 2015-06-30 |
| 1730389198 | Folusho Everton Ogunfiditimi | Physician Assistant | Henry Ford Health System, 2799 West Grand Blvd., Detroit, MI 48202 | 2007-07-23 |
| 1598897696 | Geoffrey S. Mwaungulu | Internal Medicine | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-03-12 |
| 1578606463 | Rebecca S. Lurcott | Ophthalmology | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-02-14 |
| 1184767949 | Jan Rival | Internal Medicine | Henry Ford Health System, 3031 West Grand Blvd., Detroit, MI 48202 | 2007-02-14 |
| 1295875342 | Vinaya Vallabhaneni | Preventive Medicine | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-02-07 |
| 1699821157 | Morton B. Cash | Radiology | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-01-26 |
| 1881748242 | Felix Umansky | Neurological Surgery | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-01-23 |
| 1558415901 | Sidney Goldstein | Internal Medicine | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2007-01-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584602 | Andrea Irene Martin | Audiologist | 2799 E Grand Blvd, Detroit, MI 48202 | 2020-10-05 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912529801 | Aroob Nabil Nimer Sweidan | Student in an Organized Health Care Education/Training Program | 2799 West Grand Boulvard, Department of Internal Meidicine, Cfp 1, Detroit, MI 48202 | 2020-05-13 |
| 1306485636 | Katie Burlen-davis | Registered Nurse | 9045 Woodward Ave, Detroit, MI 48202 | 2020-01-03 |
| 1407401250 | Santhalakshmi Angappan | Student in an Organized Health Care Education/Training Program | Henry Ford Hospital Medical Education Department, 2799 W. Grand Boulevard, Detroit, MI 48202 | 2019-08-08 |
| 1851945687 | Walter Mitini Etoh | Nurse Practitioner | Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 | 2019-07-30 |
| 1467913756 | Andrew Michael Schock | Emergency Medicine | Ceci Murrell-harvey, Henry Ford Hospital, 2799 W. Grand. Blvd, Cfp 046, Detroit, MI 48202 | 2019-03-28 |
| 1700363892 | Zaid Al-saheli | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvdl, Cfp 046, Hope Peck, Detroit, MI 48202 | 2018-07-23 |
| 1932690096 | Yusuf Naser Alalwan | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvd. Henry Ford Hospital - Gme Office, Detroit, MI 48202 | 2018-05-24 |
| 1568952729 | Kelvin Sellers | Massage Therapist | 832 Seward, Detriot, MI 48202 | 2018-05-14 |
| Find all providers in zip 48202 | ||||
| Taxonomy Code | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336147461 | Joseph Lawrence Lelli | Surgery | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2005-07-12 |
| 1346514254 | Masih Abdul Kader | Surgery | 3901 Beaubien St, Detroit, MI 48201-2119 | 2012-02-24 |
| 1730324096 | Lydia Joy Donoghue | Surgery | 3901 Beaubien St, Dept of Pediatric Surgery, Detroit, MI 48201-2119 | 2008-12-15 |
| 1194920041 | Justin D Klein | Surgery | 3901 Beaubien St, Carls Building 2nd Floor, Detroit, MI 48201-2119 | 2007-06-20 |
| 1598713414 | St John Hospital Corporation | Surgery | 22101 Moross Rd, Detroit, MI 48236-2148 | 2006-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235365081 | Elliot Carr Pennington | Surgery | 330 Barclay Ave Ne Ste 202, Grand Rapids, MI 49503-2525 | 2009-06-08 |
| 1346444270 | Pavan Brahmamdam | Surgery | 3535 W 13 Mile Rd # 307, Medical Office Building, Royal Oak, MI 48073-6770 | 2007-06-13 |
| 1700908423 | Susan Hershberg Adelman | Surgery | 29820 Woodland Dr, Southfield, MI 48034-1339 | 2007-04-04 |
| 1891742128 | Ajith K Kadakol | Surgery | 1701 South Blvd E Ste B75, Rochester Hills, MI 48307-6122 | 2006-05-30 |
| 1912322009 | Lakeshore Surgical Consultants, Plc | Surgery | 5400 Fort St, Suite 200, Trenton, MI 48183-4632 | 2014-02-26 |
| 1205197639 | Marcus P Haw | Surgery | 100 Michigan St Ne, 10th Floor, Mc 248, Grand Rapids, MI 49503-2560 | 2012-06-01 |
| 1114159415 | Daniel Joseph Watkins | Surgery | 330 Barclay Ave Ne, Suite 202, Grand Rapids, MI 49503-2556 | 2009-08-20 |
| 1366597544 | Covenant Medical Center, Inc. | Surgery | 1447 N Harrison St, Saginaw, MI 48602-4727 | 2007-01-25 |
| 1679622765 | Robert Robert Connors | Surgery | 330 Barclay Ave Ne, Suite 202, Grand Rapids, MI 49503-2556 | 2007-01-09 |
| 1326197625 | James Michael Decou | Surgery | 330 Barclay Ave Ne, Suite 202, Grand Rapids, MI 49503-2556 | 2007-01-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.