Provider Demographics
NPI:1528565629
Name:SHAH-SIEGEL, PINKEY (DO)
Entity Type:Individual
Prefix:
First Name:PINKEY
Middle Name:
Last Name:SHAH-SIEGEL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:PINKEY
Other - Middle Name:
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:231 ALBERT SABIN WAY PO BOX 0531
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45267-2827
Mailing Address - Country:US
Mailing Address - Phone:513-558-6356
Mailing Address - Fax:512-558-0995
Practice Address - Street 1:3188 BELLEVUE AVENUE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219
Practice Address - Country:US
Practice Address - Phone:513-584-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-06
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58.03032207L00000X
390200000X
OH34016151207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program