SHAD M HINES DO - NPI 1790487858 - Student in an Organized Health Care Education/Training Program in Warren, MI

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

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About Shad M Hines Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHAD M HINES DO (NPI 1790487858) is an individual student in an organized health care education/training program in Warren, Michigan and active in the NPI registry since March 2023. He maintains a secondary practice location in Warren.

NPPES Registry Identity

NPI1790487858

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameSHAD M HINESCredential: DO

Location Address11900 E 12 MILE RD STE 205Warren, MI 48093-3499

Mailing Address10914 E 23rd AveSpokane Valley, WA 99206-5636

Phone(586) 582-7034

Fax(586) 582-7034

Sole ProprietorNo

Enumeration DateMarch 21, 2023

Last NPPES UpdateJune 30, 20242 updates tracked since enumeration

NPPES CertifiedJune 30, 2024

✔ NPI 1790487858 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

11900 E 12 MILE RD STE 205, Warren, MI 48093

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