Bushra Shah Md Pllc | |
100 Vigne Dr Little Rock AR 72223-4581 | |
(501) 552-4777 | |
Not Available |
Full Name | Bushra Shah Md Pllc |
---|---|
Speciality | Internal Medicine |
Location | 100 Vigne Dr, Little Rock, Arkansas |
Authorized Official Name and Position | Bushra Shah (OWNER) |
Authorized Official Contact | 5015524777 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Bushra Shah Md Pllc 100 Vigne Dr Little Rock AR 72223-4581 Ph: (501) 552-4777 | Bushra Shah Md Pllc 100 Vigne Dr Little Rock AR 72223-4581 Ph: (501) 552-4777 |
NPI Number | 1992239479 |
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Provider Enumeration Date | 04/12/2017 |
Last Update Date | 04/12/2017 |
Medicare PECOS PAC ID | 0345517264 |
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Medicare Enrollment ID | O20170525000717 |
Identifier | Type | State | Issuer |
---|---|---|---|
1992239479 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0300X | Internal Medicine - Geriatric Medicine | E-3672 (Arkansas) | Primary |
Provider Name | Bushra Shah |
---|---|
Provider Type | Practitioner - Geriatric Medicine |
Provider Identifiers | NPI Number: 1417910670 PECOS PAC ID: 3476537606 Enrollment ID: I20040615001861 |
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