Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 34.014148 | OH |
N | 2080P0204X | Pediatric Emergency Doctor | 34014148 | OH |
NPI | 1194264218 |
---|---|
Provider Name | Mr. Nasir Shahrestani |
First Address | Columbus, OH 43201-3139 |
Second Address | Columbus, OH 43228-1607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2017 |
Last Update Date | 21/08/2020 |