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Organization

AAJAY N SHAH MD PLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. AAJAY N SHAH MD (OWNER)
(517) 214-9119
Entity
Organization

Contact information

Practice address
2395 JOLLY RD, SUITE 145, OKEMOS, MI 48864
(517) 214-9119
(517) 574-5957
Mailing address
2395 JOLLY RD, SUITE 145, OKEMOS, MI 48864
(517) 214-9119
(517) 574-5957

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
4301055396
MI
207RC0000X
Cardiovascular Disease Physician
Primary
4301055396
MI
363AM0700X
Medical Physician Assistant
5601003722
MI
363AM0700X
Medical Physician Assistant
5601003787
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
010056753
RAILROAD MEDICARE
MI
01
0603311491
BLUE CROSS BLUE SHIELD
MI
01
2500022
PHYSICIANS HEALTH PLAN
MI
05
4673296
MI
01
P90592
BLUE CARE NETWORK
MI
Enumeration date
05/08/2006
Last updated
10/19/2011
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