MEDICARE: SHAMA AHUJA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	4301040698	MI

General Provider Information

NPI Number	:	1598160939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAMA AHUJA

Provider Business Mailing Address
First Line	:	12459 WHITE TAIL CT
Second Line	:
City	:	PLYMOUTH
State	:	MI
Zip	:	48170-2875
Country	:	US
Telephone Number	:	734-455-4815
Fax Number	:	734-455-4815

Provider Business Practice Location Address
First Line	:	12459 WHITE TAIL CT
Second Line	:
City	:	PLYMOUTH
State	:	MI
Zip	:	48170-2875
Country	:	US
Telephone Number	:	734-455-4815
Fax Number	:	734-455-4815

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/28/2014
Last Update Date	:	10/28/2014

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Directions to “ SHAMA AHUJA ” Practice Location

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