Healthcare Provider Details

I. General information

NPI: 1225295504
Provider Name (Legal Business Name): RUPAL SHAH BHATNAGAR D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 S MAIN ST STE B
CHELSEA MI
48118-1479
US

IV. Provider business mailing address

1307 S MAIN ST STE B
CHELSEA MI
48118-1479
US

V. Phone/Fax

Practice location:
  • Phone: 734-896-5584
  • Fax: 734-749-6076
Mailing address:
  • Phone: 248-330-6242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036124494
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: