Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 01081795A | IN |
Y | 207ND0101X | MOHS-Micrographic Surgeon | 01081795A | IN |
N | 207NS0135X | Procedural Dermatology | 01081795A | IN |
NPI | 1043605173 |
---|---|
Provider Name | Mihir Minesh Shah |
First Address | Westlake, OH 44145-2399 |
Second Address | Westlake, OH 44145-2399 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2015 |
Last Update Date | 06/02/2021 |