DR. LORIEN SHACK


Address: 6071 W Outer Dr, Detroit, MI 48235-2624
Phone: 3139663155

DR. LORIEN SHACK (NPI# 1164710406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1164710406
Entity Type Individual
Full Name DR. LORIEN SHACK
Credential M.D.
Practice Address 6071 W Outer Dr
Detroit
MI 48235-2624
Mailing Address 6071 West Outer Drive
Detroit
MI 48235
Practice Telephone 3139663155
Enumeration Date 2011-07-20
Last Update Date 2019-06-03
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208D00000X General Practice 4301099212 MI Allopathic & Osteopathic Physicians
N 390200000X Student in an Organized Health Care Education/Training Program 4301099212 MI Student, Health Care

Office Location

Street Address 6071 W OUTER DR
City DETROIT
State MI
Zip Code 48235-2624

Providers in the same location

NPI Name Taxonomy Address Enumeration
1205836806 Select Specialty Hospital - Northwest Detroit Inc Long Term Care Hospital 6071 W Outer Dr, 7th Floor, Detroit, MI 48235-2624 2005-07-26
1356965198 Anielle Ball Registered Nurse 6071 W Outer Dr, Detroit, MI 48235-2624 2020-06-07
1427672708 Nitesh Kumar Byrappa Student in an Organized Health Care Education/Training Program 6071 W Outer Dr, Detroit, MI 48235-2624 2020-06-03
1992327969 Chandima Jinani Herath Mudiyanselage Student in an Organized Health Care Education/Training Program 6071 W Outer Dr, Detroit, MI 48235 2020-05-13
1790307783 Patrick Riedy Student in an Organized Health Care Education/Training Program 6071 W Outer Dr, Detroit, MI 48235-2624 2020-05-12
1518589878 Nnadozie Okoroafor Student in an Organized Health Care Education/Training Program 6071 W Outer Dr, Detroit, MI 48235-2624 2020-05-09
1720609803 Charmayne Gail Cooley Student in an Organized Health Care Education/Training Program 6071 W Outer Dr, Detroit, MI 48235-2624 2020-04-30
1841811890 Noren Din Internal Medicine 6071 W Outer Dr, Detroit, MI 48235-2624 2020-04-30
1962023069 Haseeb Khan Student in an Organized Health Care Education/Training Program 6071 W Outer Dr, Detroit, MI 48235-2624 2020-04-29
1285255570 Edward Park Student in an Organized Health Care Education/Training Program 6071 W Outer Dr, Detroit, MI 48235-2624 2020-04-28
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1457976292 Ali Nauman Khan Student in an Organized Health Care Education/Training Program Detroit Medical Center-sinai Grace Hospital, 6071 W. Outer Driver, Detroit, MI 48235 2020-06-08
1629690565 Faseeha Arshad Gondal Student in an Organized Health Care Education/Training Program Detroit Medical Center Sinai Grace Hospital, 6071 Outer Dr W. Detroit, Mi 48235, United States, Detroit, MI 48235 2020-05-14
1902428832 Muhanad Abou Touk Student in an Organized Health Care Education/Training Program Dmc - Sinai Grace Hospital, Department of Internal Medi, 6071, W. Outer Drive, Detroit, MI 48235 2020-05-14
1780206730 Ahmad Mismar Student in an Organized Health Care Education/Training Program Detroit Medical Center - Sinai Grace Hospital, Departme, 6071 West Outer Drive, Detroit, MI 48235 2020-05-13
1023630589 Joao Paulo Fontana Bragagnollo Student in an Organized Health Care Education/Training Program 6071 W Outer Drive-sinai Grace Hospital, Department of Medicine 4th Floor M-406, Detroit, MI 48235 2020-05-07
1881216216 Mohammad Awad Jaber Student in an Organized Health Care Education/Training Program 6071 W. Outer Drive, Dmc Sinai-grace Hospital, Detroit, MI 48235 2020-05-07
1366064818 Syeda Busmah Owais Student in an Organized Health Care Education/Training Program 6071 Outer Drive, Sinai Grace Hospital, Department of I, Detroit, MI 48235 2020-05-07
1184245680 Sushmitha Nanja Reddy Student in an Organized Health Care Education/Training Program Detroit Medcen Sinai Grace Hospital Dpt of Internal Med, 6071 W Outer Drive, Detroit, MI 48235 2020-05-06
1972164796 Jack Phillip Tomen Student in an Organized Health Care Education/Training Program Sinai - Grace Hospital, 6071 Outer Drive W, Department of Medicine - 4 Main, Detroit, MI 48235 2019-06-24
1346809464 Anusha Bapatla Student in an Organized Health Care Education/Training Program 4 Main, 6071 West Outer Drive, Sinai-grace Hospital, Department of Internal Medicine, Detroit, MI 48235 2019-06-12
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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1215422555 The Natural Momma Me Initiative General Practice 11000 W Mcnichols Rd Ste 212, Detroit, MI 48221-2389 2018-06-28
1629515770 Pinnacle Medical Group General Practice 535 Griswold St Ste 212, Detroit, MI 48226-3604 2017-01-27
1104170281 Bryant Medical Staffing Services Group Inc. General Practice 1753 E 7 Mile Rd, Detroit, MI 48203-2159 2012-10-29
1316290281 Higher Standard Therapeutics Rehab PC General Practice 14402 Gratiot Ave., Detroit, MI 48205-2307 2012-10-17
1578845400 Hands Helping You LLC General Practice 17181 Pontchartrain Blvd, Detroit, MI 48203-1774 2011-09-16
1487944385 Better Days Adult Activity Center LLC General Practice 17251 Huntington Rd, Detroit, MI 48219-3520 2011-04-12
1669788121 Az Medical Services Management LLC General Practice 7405 Puritan St, Detroit, MI 48238-1207 2010-08-23
1871720342 Vernor Mc Inc General Practice 7649 W Vernor Hwy, Detroit, MI 48209-1513 2009-06-11
1003070723 Mark Beard General Practice 5700 W Vernor Hwy, Detroit, MI 48209 2008-07-11
1184892754 David Jonnalagadda Md PC General Practice 6001 W Outer Dr Ste 320, Detroit, MI 48235-2626 2008-02-15
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Competitor

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City DETROIT
Zip Code 48235

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Dataset Information

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.

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