Basic Information
| Provider Information | |||||||||
| NPI: | 1861780082 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JAWAD A SHAH MD PC | ||||||||
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| OtherOrganizationName: | INSIGHT PHYSICAL THERAPY & REHAB CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4800 S SAGINAW ST | ||||||||
| Address2: | SUITE 1805 | ||||||||
| City: | FLINT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 485072677 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102759108 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3390 N STATE RD | ||||||||
| Address2: | SUITE B | ||||||||
| City: | DAVISON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 484231154 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8102759610 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2011 | ||||||||
| LastUpdateDate: | 07/21/2011 | ||||||||
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| AuthorizedOfficialLastName: | IQBAL | ||||||||
| AuthorizedOfficialFirstName: | AMER | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8102759371 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | JAWAD A SHAH MD PC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.