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Individual

DR. AAJAY SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
215 E MANSION ST, SUITE 2F, MARSHALL, MI 49068-1559
(269) 789-8272
(269) 789-8273
Mailing address
215 E MANSION ST, SUITE 2F, MARSHALL, MI 49068-1559
(269) 789-8272
(269) 789-8273

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
4301055396
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000792050
BCBS
IN
01
010056753
RAILROAD MEDICARE
MI
01
0331149
BCBS AND BCN PIN
MI
01
0603311491
BCBSM PROVIDER
MI
05
200084480
IN
01
2500022
PHP OF MI
MI
01
4301055396
STATE LICENSE
MI
05
4673296
MI
01
861085123
FEDERAL TAX ID
MI
01
P90592
BLUE CARE NETWORK
MI
Enumeration date
05/26/2006
Last updated
12/08/2014
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