Provider Demographics
NPI:1306192794
Name:ZAHEER A SHAH MD INC
Entity Type:Organization
Organization Name:ZAHEER A SHAH MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZAHEER
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-499-2209
Mailing Address - Street 1:4665 DOUGLAS CIR NW
Mailing Address - Street 2:SUITE 103
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3673
Mailing Address - Country:US
Mailing Address - Phone:330-499-2209
Mailing Address - Fax:330-499-5884
Practice Address - Street 1:4665 DOUGLAS CIR NW
Practice Address - Street 2:SUITE 103
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-3673
Practice Address - Country:US
Practice Address - Phone:330-499-2209
Practice Address - Fax:330-499-5884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-03
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-2315208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA79931Medicare UPIN
OH0453898Medicare UPIN