Provider Demographics
NPI:1578583605
Name:SHAH, ARSHAD ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:ARSHAD
Middle Name:ALI
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 1:3535 SOUTHERN BLVD
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-1221
Mailing Address - Country:US
Mailing Address - Phone:937-395-6665
Mailing Address - Fax:937-395-6668
Practice Address - Street 1:3535 SOUTHERN BLVD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-1221
Practice Address - Country:US
Practice Address - Phone:937-395-6665
Practice Address - Fax:937-395-6668
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.088477208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2817634Medicaid
PA1017247320001Medicaid
PA820449OtherFIRST PRIORITY HEALTH
PA7705868OtherAETNA
PA45062OtherHEALTHAMERICA
PA1877245OtherHIGHMARK BLUE SHIELD
PAP00343949Medicare PIN
PA103492Medicare PIN
PA45062OtherHEALTHAMERICA
OH2817634Medicaid
OHH100514Medicare PIN