Basic Information
| Provider Information | |||||||||
| NPI: | 1922312487 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARPER-SHANKIE | ||||||||
| FirstName: | MEGHAN | ||||||||
| MiddleName: | REGINA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26901 BEAUMONT BLVD | ||||||||
| Address2: | STE 3D | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480333849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9475221864 | ||||||||
| FaxNumber: | 9475220307 | ||||||||
| Practice Location | |||||||||
| Address1: | 28595 ORCHARD LAKE RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | FARMINGTON HILLS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483342977 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485530010 | ||||||||
| FaxNumber: | 2485535957 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2010 | ||||||||
| LastUpdateDate: | 03/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MT197524 | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080P0008X | 4301104041 | MI | Y | Allopathic & Osteopathic Physicians | Pediatrics | Neurodevelopmental Disabilities |
No ID Information.