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Anjalee N Shah

Student in an Organized Health Care Education/Training Program

Student, Health Care

3000 Arlington Ave, Toledo, OH 43614-2595

PECOS Enrollment

This provider is enrolled in PECOS as ANJALEE SHAH.

Based on the most recent information from CMS, provider Anjalee N Shah is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1306209648
Provider Type
Individual
Full Name
Shah, Anjalee N
Title
Dr.
Credential
DMD

Gender
Female
Sole Proprietor
No
Enumeration Date
4/4/2016
Last Updated
5/12/2020

Contact Information

Practice Location

3000 Arlington Ave, Toledo, OH 43614-2595

(419) 383-3805

(419) 383-6127

Mailing Location

1894 Lexington Dr, Troy, MI 48084-5713

(248) 703-8906

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 390200000X Primary	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer
Code 1223G0001X	Description Dentist Dental Providers	License 2901022117 Michigan
Code 1223G0001X	Description Dentist Dental Providers	License 102007 California

Anjalee N Shah

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

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Description

License

Code

Description

License

Code

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License

Code

Description

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