Provider Demographics
NPI:1003551185
Name:SHAH, RESHASHREE (MD)
Entity type:Individual
Prefix:MRS
First Name:RESHASHREE
Middle Name:
Last Name:SHAH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 EAST MARKET STREET, 7TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44483
Mailing Address - Country:US
Mailing Address - Phone:330-675-5714
Mailing Address - Fax:330-675-5721
Practice Address - Street 1:1350 EAST MARKET STREET, 7TH FLOOR
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:OH
Practice Address - Zip Code:44483
Practice Address - Country:US
Practice Address - Phone:330-841-9647
Practice Address - Fax:330-841-9645
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-03
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2025-00635207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program