DR. SHADY S SHEBAK M.D. NPI 1629416169

NPI Information

NPI: 1629416169
Provider Name: DR. SHADY S SHEBAK, M.D.
Classification: Psychiatry & Neurology - 2084P0804X
Entity Type: Individual

Specialization: Child & Adolescent Psychiatry

Organization: ARMAN C MOSHYEDI MD PLLC

PECOS Registration: Yes

Address:
3815 PELHAM ST STE 13
DEARBORN, MI
ZIP 48124
Phone: (131) 368-0080
Get Directions

DR. Shady S Shebak, M.D. is a child and adolescent psychiatry psychiatry neurology in Dearborn, MI with 11 years of experience. The provider is child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. DR. Shady S Shebak, M.D. NPI is 1629416169. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3815 PELHAM ST STE 13
DEARBORN, MI
ZIP 48124-852
Phone: (131) 368-0080
Fax: (313) 241-9342

The NPI 1629416169 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/6/2013 and was last updated on 8/10/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program		4301110580	MICHIGAN	No
2	2084A0401X	Psychiatry & Neurology	Addiction Medicine	4301110580	MICHIGAN	No
3	2084P0800X	Psychiatry & Neurology	Psychiatry	4301110580	MICHIGAN	No
4	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	99999	MICHIGAN	Yes
5	2084P0804X	Psychiatry & Neurology	Child & Adolescent Psychiatry	4301110580	MICHIGAN	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	831910484	MEDICAID	MICHIGAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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