Individual
DR. BHAVNA RAJESH SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 788-4897
Mailing address
4907 COUNTRY LN, P O BOX 4363, JACKSON, MI 49201-9787
(517) 784-3406
(517) 784-6891
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4301048648
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1671387#10
—
MI
01
—
2503800652
BCBS ID NUMBER
MI
Enumeration date
07/18/2006
Last updated
03/07/2023
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