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Individual

UPENDRA SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
12805 ESCANABA DR, DEWITT, MI 48820-8628
(517) 367-5520
(517) 367-5521
Mailing address
401 S BALLENGER HWY, FLINT, MI 48532-3638
(810) 342-1000
(810) 342-1590

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301058499
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01795
AETNA
MI
01
0700183
PHYSICIANS HEALTH PLAN
MI
01
160C311260
COMMUNITY BLUE PPO
MI
01
252500
HEALTH ADVANTAGE NETWORK
MI
05
4155746
MI
01
F03502
HEALTH NET FEDERAL SERVIC
MI
Enumeration date
01/24/2006
Last updated
12/18/2013
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