Bhanu J. Shah MD PC

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

31435 Issued in MI

Legal business name

BHANU J. SHAH MD PC

Practice address

29175 Ryan Rd
Warren, MI 48092-4243

Phone

(586) 574-2190

Fax

(586) 574-2203

NPI assigned

Nov 4, 2009

Last updated

Mar 25, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bhanu J Shah, MDNPI 1295743896

Title

President

Phone

(586) 574-2190

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bhanu J Shah, MD

  • Obstetrics & Gynecology Physician
  • Sterling Heights, MI
  • NPI 1295743896
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269475200000",
    "number": "1427385954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29175 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48092",
            "telephone_number": "586-574-2190",
            "fax_number": "586-574-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29175 RYAN RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480924243",
            "telephone_number": "586-574-2190",
            "fax_number": "586-574-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BHANU J. SHAH MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-04",
        "last_updated": "2010-03-25",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "BHANU",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-574-2190",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "31435",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIELD",
            "identifier": "0502020",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1059764",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in Warren, MI
• Providers in Warren, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.