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General NPI Number Information
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NPI Number | 1245767243
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Entity Type | Organization
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Legal Business Name | JAWAD A SHAH MD PC
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Dates
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Enumeration Date | 05/22/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4800 S SAGINAW ST
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City | FLINT
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State | MI
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Zip | 48507-2677
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Country | US
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Telephone | 810-275-9108
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Fax | 810-963-2881
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Provider Business Mailing Address
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Address Line | 4800 S SAGINAW ST
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City | FLINT
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State | MI
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Zip | 48507-2677
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Country | US
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Telephone | 810-275-9108
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Fax | 810-963-2881
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAWAD A SHAH
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Credential | MD
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Telephone | 810-732-8336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 23D2077430
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License Number State | MI
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