Provider Demographics
NPI:1033683776
Name:SHALINI BAHL MD LLC
Entity Type:Organization
Organization Name:SHALINI BAHL MD LLC
Other - Org Name:ACE DERMATOLOGY, LASER AND COSMETIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHALINI
Authorized Official - Middle Name:
Authorized Official - Last Name:BAHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-284-2536
Mailing Address - Street 1:1029 STAY LIT CT
Mailing Address - Street 2:
Mailing Address - City:BELLBROOK
Mailing Address - State:OH
Mailing Address - Zip Code:45305-8981
Mailing Address - Country:US
Mailing Address - Phone:937-284-2536
Mailing Address - Fax:
Practice Address - Street 1:8363 YANKEE ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45458-1809
Practice Address - Country:US
Practice Address - Phone:937-885-4412
Practice Address - Fax:937-977-1705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty