MEDICARE: DR. ASHWIN H SHAH MD

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	208800000X	Urology Physician	4301043074	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3405810232	OTHER	MI	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	02011	OTHER	MI	PARAMOUNT
4	0514942	OTHER	OH	PALMETTO GBA OHIO CLAIMS
5	P00114142	OTHER		PALMETTO GBA

General Provider Information

NPI Number	:	1710983812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHWIN H SHAH MD

Provider Business Mailing Address
First Line	:	360 SANTURE ST
Second Line	:
City	:	MONROE
State	:	MI
Zip	:	48162-4128
Country	:	US
Telephone Number	:	734-241-3900
Fax Number	:	734-241-3538

Provider Business Practice Location Address
First Line	:	730 N MACOMB ST
Second Line	:	STE 319
City	:	MONROE
State	:	MI
Zip	:	48162
Country	:	US
Telephone Number	:	734-241-3900
Fax Number	:	734-241-3538

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	04/15/2025

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Directions to “ DR. ASHWIN H SHAH MD” Practice Location

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