Provider Demographics
NPI:1952678914
Name:JAWAD A SHAH MD PC
Entity Type:Organization
Organization Name:JAWAD A SHAH MD PC
Other - Org Name:INSIGHT PAIN MANAGEMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NADIR
Authorized Official - Middle Name:
Authorized Official - Last Name:IJAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-275-9333
Mailing Address - Street 1:4800 S SAGINAW ST
Mailing Address - Street 2:SUITE 1805
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-2677
Mailing Address - Country:US
Mailing Address - Phone:810-275-9108
Mailing Address - Fax:810-963-2881
Practice Address - Street 1:4800 S SAGINAW ST
Practice Address - Street 2:SUITE 1815
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48507-2677
Practice Address - Country:US
Practice Address - Phone:810-275-9152
Practice Address - Fax:810-213-0228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-18
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty