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Contact Information

MUKUND SHAH, MD
3800 HOLLYWOOD RD
SUITE 102
SAINT JOSEPH, MI49085-8510
 Phone: 269-428-2727
 Fax: 269-428-0377
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for MUKUND SHAH · (Male)

NPI # 1013086446
Status Active
Credentials MD
Entity Individual
Enumeration date 11/07/2006
Last updated 07/08/2007 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • MI License # 4301039964
  • MI Medicaid 1736679
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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