Provider Demographics
NPI:1235335118
Name:BOHN, SHIVA (MD)
Entity Type:Individual
Prefix:MRS
First Name:SHIVA
Middle Name:
Last Name:BOHN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:SHIVA
Other - Middle Name:A
Other - Last Name:NOBAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:930 MADISON AVE. #470
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38163
Mailing Address - Country:US
Mailing Address - Phone:901-448-5883
Mailing Address - Fax:901-448-1299
Practice Address - Street 1:930 MADISON AVE #400
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38103
Practice Address - Country:US
Practice Address - Phone:901-448-6650
Practice Address - Fax:901-302-2500
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011010506207W00000X
TN48600207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology