Individual
BUSHRA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 SAINT VINCENT CIR, SUITE 210, LITTLE ROCK, AR 72205-5405
(501) 552-4777
(501) 552-4570
Mailing address
1 SAINT VINCENT CIR, SUITE 210, LITTLE ROCK, AR 72205-5405
(501) 552-4777
(501) 552-4448
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
E-3672
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155015001
—
AR
01
—
4070011000
QUALCHOICE
AR
01
—
P00185272
MEDICARE RAILROAD
AR
Enumeration date
04/10/2006
Last updated
12/21/2015
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