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General NPI Number Information
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NPI Number | 1992204341
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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 | 02/12/2018
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Last Update Date | 02/12/2018
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Provider Practice Location Address
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Address Line | 4400 S SAGINAW ST STE 1370
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City | FLINT
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State | MI
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Zip | 48507-2668
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Country | US
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Telephone | 810-732-8336
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Fax | 810-213-0239
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Provider Business Mailing Address
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Address Line | 4400 S SAGINAW ST STE 1370
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City | FLINT
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State | MI
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Zip | 48507-2668
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Country | US
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Telephone | 810-732-8336
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Fax | 810-213-0239
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Authorized Official
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Title or Position | PRESIDENT
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Name | 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 | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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