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Individual

JAYESH R SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
500 E POTTAWATAMIE ST, TECUMSEH, MI 49286-2018
(517) 423-2141
Mailing address
2000 GREEN RD, SUITE 300, ANN ARBOR, MI 48105-1598

Taxonomy

Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
084511
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4685027
MI
05
4718360
MI
01
JS084511
BC/BS
MI
Enumeration date
06/06/2006
Last updated
01/07/2009
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