Individual ProviderShane MckennaInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address3601 W 13 Mile Rd, Royal Oak, MI 48073-6712(248) 551-3000PECOS EnrollmentBased on the most recent information from CMS, provider Shane Mckenna is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 9:21 AM.Profile DetailsProvider ID1013608009Provider TypeIndividualFull NameMckenna, ShaneCredentialMDGenderMaleSole ProprietorNoEnumeration Date5/19/2023Last Updated5/19/2023Contact InformationPractice LocationPractice Address3601 W 13 Mile Rd, Royal Oak, MI 48073-6712Phone(248) 551-3000Fax(248) 551-9425Mailing LocationMailing Address3601 W 13 Mile Rd Ofc, Royal Oak, MI 48073-6712PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense4351051399Michigan