Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207W00000X | Ophthalmologist | 28311 | OK |
N | 207W00000X | Ophthalmologist | 4301093697 | MI |
Y | 207WX0107X | Retina Specialist | 28311 | OK |
NPI | 1013951409 |
---|---|
Provider Name | Vinay Ashok Shah |
First Address | Oklahoma City, OK 73104-5014 |
Second Address | Oklahoma City, OK 73104-5014 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 15/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200344830A | (05) | OK |