Provider Demographics
NPI:1972707560
Name:SHAH, SHILPA KAMAL (DO)
Entity Type:Individual
Prefix:DR
First Name:SHILPA
Middle Name:KAMAL
Last Name:SHAH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4388 CENTENNIAL DR
Mailing Address - Street 2:APT 206
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45227-2659
Mailing Address - Country:US
Mailing Address - Phone:281-841-6023
Mailing Address - Fax:
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 2005
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-636-4825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH009880208000000X
TXN2292208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
3851526913OtherMYUTMB 3851526913-COMMERCIAL NUMBER
3851526913OtherMYUTMB 3851526913-COMMERCIAL NUMBER