Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 159960 | MA |
Y | 204F00000X | Transplant Surgeon | 35.099739 | OH |
NPI | 1811962327 |
---|---|
Provider Name | Shimul A Shah |
First Address | Cincinnati, OH 45263-6256 |
Second Address | Cincinnati, OH 45219-2489 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2006 |
Last Update Date | 12/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3208133 | (05) | MA |