| Christina Mubarak Shanti, MD | |
|
Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | |
| (313) 916-9106 | |
| (313) 916-1249 |
| Full Name | Christina Mubarak Shanti |
|---|---|
| Gender | Female |
| Speciality | Surgery - Pediatric Surgery |
| Location | Henry Ford Health System, Detroit, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124015565 | NPI | - | NPPES |
| 1396817714 | Other | MI | GROUP NPI |
| 4735568 | Medicaid | MI | |
| 4864707 | Medicaid | MI | |
| 4735577 | Medicaid | MI | |
| CS070255 | Other | COMMERCIAL-COMMERCIAL NUMBER | |
| CS070255 | Other | CHAMPUS-CHAMPUS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2086S0120X | Surgery - Pediatric Surgery | 4301070255 (Michigan) | Primary |
| Entity Name | Michigan Pediatric Surgery Associates Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1396817714 PECOS PAC ID: 1254238165 Enrollment ID: O20031218000155 |
| Entity Name | Ascension St John Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043478910 PECOS PAC ID: 3173424082 Enrollment ID: O20040115000409 |
| Mailing Address | Practice Location Address |
|---|---|
| Christina Mubarak Shanti, MD Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 Ph: (313) 916-9106 | Christina Mubarak Shanti, MD Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 Ph: (313) 916-9106 |
Kaitlyn Dobesh, MD Surgery Medicare: Medicare Enrolled Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-2600 | |
Dr. Bellal Ali Joseph, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-3056 Fax: 313-916-9920 | |
Charles Edward Lucas, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 4160 John R St, Suite 615, Detroit, MI 48201 Phone: 313-745-4195 Fax: 313-993-8669 | |
Christopher Paul Cassell, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 22101 Moross Rd, Detroit, MI 48236 Phone: 313-343-4000 | |
Mitchell Ross Weaver, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-3156 Fax: 313-916-3023 | |
Alexander Marinica, Surgery Medicare: Accepting Medicare Assignments Practice Location: 6071 W Outer Dr Ste 121, Detroit, MI 48235 Phone: 313-966-3222 | |
Dr. Rachel Wobig, MD Surgery Medicare: Medicare Enrolled Practice Location: 2799 W Grand Blvd, Detroit, MI 48202 Phone: 313-916-5071 Fax: 313-916-9920 |