Individual
JAY JITENDRAKUMAR SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 REHILL AVE, SOMERVILLE, NJ 08876-2519
(313) 343-7774
Mailing address
22201 MOROSS RD STE 50, DETROIT, MI 48236-2166
(313) 343-7774
(313) 343-8747
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
35.144054
OH
207RC0000X
Cardiovascular Disease Physician
25MA12194400
NJ
207RI0011X
Interventional Cardiology Physician
Primary
25MA12194400
NJ
Other
Enumeration date
03/29/2017
Last updated
07/11/2024
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