Healthcare Provider Details

I. General information

NPI: 1679373120
Provider Name (Legal Business Name): SHAHZAIB CHUGHTAI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2025
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 COOPER AVE
SAGINAW MI
48602-5383
US

IV. Provider business mailing address

783 EAGLE AVE
ANN ARBOR MI
48103-8888
US

V. Phone/Fax

Practice location:
  • Phone: 989-583-0000
  • Fax:
Mailing address:
  • Phone: 734-223-3794
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0116042743
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: