Provider Demographics
NPI:1639401821
Name:DR. SHAHS FINE NEEDLE ASPIRATION CLINIC, LLC
Entity Type:Organization
Organization Name:DR. SHAHS FINE NEEDLE ASPIRATION CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:R
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-517-5575
Mailing Address - Street 1:5965 RENAISSANCE PL BLDG SUITE3
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623-4728
Mailing Address - Country:US
Mailing Address - Phone:419-517-5575
Mailing Address - Fax:888-267-5881
Practice Address - Street 1:5965 RENAISSANCE PL BLDG SUITE3
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-4728
Practice Address - Country:US
Practice Address - Phone:419-517-5575
Practice Address - Fax:888-267-5881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-12
Last Update Date:2010-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35062467SOH207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty