Provider Demographics
NPI:1275246167
Name:SHAH, MOHAMMAD NABEEL (APRN)
Entity Type:Individual
Prefix:MR
First Name:MOHAMMAD
Middle Name:NABEEL
Last Name:SHAH
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2960 MACK RD STE 200
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-5300
Mailing Address - Country:US
Mailing Address - Phone:513-829-1700
Mailing Address - Fax:513-829-5333
Practice Address - Street 1:2960 MACK RD STE 200
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-5300
Practice Address - Country:US
Practice Address - Phone:513-829-1700
Practice Address - Fax:513-829-5333
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.0032272363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner