Provider Demographics
NPI:1043605173
Name:SHAH, MIHIR MINESH (MD)
Entity Type:Individual
Prefix:
First Name:MIHIR
Middle Name:MINESH
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26908 DETROIT RD STE 103
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-2399
Mailing Address - Country:US
Mailing Address - Phone:440-249-0274
Mailing Address - Fax:440-808-1718
Practice Address - Street 1:26908 DETROIT RD STE 103
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-2399
Practice Address - Country:US
Practice Address - Phone:440-249-0274
Practice Address - Fax:440-808-1718
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01081795A207N00000X, 207ND0101X
OH35.138954207N00000X, 207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207N00000XAllopathic & Osteopathic PhysiciansDermatology