Organization
MICHIGAN PHYSICIANS GROUP, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DINESH SHAH MD (MEDICAL DOCTOR/OWNER)
(248) 583-0100
Entity
Organization
Contact information
Practice address
2025 W LONG LAKE RD, SUITE 106, TROY, MI 48098-4100
(248) 952-1540
(248) 541-6862
Mailing address
30855 JOHN R RD, MADISON HEIGHTS, MI 48071-5213
(248) 583-0100
(248) 583-4894
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301065276
MI
2084N0400X
Neurology Physician
4301066469
MI
213E00000X
Podiatrist
5315028842
MI
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6388420003
MEDICARE DME PTAN
—
01
—
OF36177
BCBSM
MI
Enumeration date
09/13/2010
Last updated
05/04/2011
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