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General NPI Number Information
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NPI Number | 1013174382
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Entity Type | Organization
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Legal Business Name | TARA P SHAH ,MD , PC
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 03/03/2009
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Provider Practice Location Address
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Address Line | 2950 CROOKS ROAD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-2950
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Country | US
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Telephone | 248-853-5093
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Fax |
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Provider Business Mailing Address
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Address Line | 2950 CROOKS ROAD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-2950
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Country | US
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Telephone | 248-853-5093
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TARA P SHAH
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Credential | M.D
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Telephone | 248-853-5093
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | TS036111
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License Number State | MI
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