Provider Demographics
NPI:1720287386
Name:SHAH, KUNJESH PARESH (MD)
Entity Type:Individual
Prefix:
First Name:KUNJESH
Middle Name:PARESH
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:45569 VAN DYKE AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:UTICA
Mailing Address - State:MI
Mailing Address - Zip Code:48317-5617
Mailing Address - Country:US
Mailing Address - Phone:586-258-8791
Mailing Address - Fax:586-799-4474
Practice Address - Street 1:45569 VAN DYKE AVE STE 3
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:MI
Practice Address - Zip Code:48317-5617
Practice Address - Country:US
Practice Address - Phone:586-258-8791
Practice Address - Fax:586-799-4474
Is Sole Proprietor?:No
Enumeration Date:2007-07-13
Last Update Date:2023-10-23
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Provider Licenses
StateLicense IDTaxonomies
MI4301090856207QA0505X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine