Provider Demographics
NPI:1447552849
Name:SHALABI, HANI S
Entity type:Individual
Prefix:DR
First Name:HANI
Middle Name:S
Last Name:SHALABI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38242 REMINGTON PARK
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-3776
Mailing Address - Country:US
Mailing Address - Phone:419-450-5119
Mailing Address - Fax:
Practice Address - Street 1:4201 ST.ANTONIE STREET
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-745-4525
Practice Address - Fax:313-993-0085
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.018481390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program