MEDICARE: KHUSHBOO R SHAH

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	225100000X	Physical Therapist	5501017654	MI

General Provider Information

NPI Number	:	1649627076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KHUSHBOO R SHAH

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	422-370-2438
Fax Number	:

Provider Business Practice Location Address
First Line	:	2532 S ADAMS RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48309-5508
Country	:	US
Telephone Number	:	947-226-2379
Fax Number	:

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

Provider Enumeration Date	:	05/16/2016
Last Update Date	:	03/03/2026

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Directions to “ KHUSHBOO R SHAH ” Practice Location

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