Provider Demographics
NPI:1992208268
Name:SHAH, AKASH (PT)
Entity Type:Individual
Prefix:
First Name:AKASH
Middle Name:
Last Name:SHAH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27423 PARKVIEW BLVD APT 5210
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48092-3631
Mailing Address - Country:US
Mailing Address - Phone:586-436-9747
Mailing Address - Fax:
Practice Address - Street 1:15540 BEECH DALY RD
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-3804
Practice Address - Country:US
Practice Address - Phone:313-537-1110
Practice Address - Fax:313-537-1110
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-13
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501018126225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist