Provider Demographics
NPI:1720069776
Name:SHAHBABIAN, SET (MD)
Entity Type:Individual
Prefix:DR
First Name:SET
Middle Name:
Last Name:SHAHBABIAN
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:PO BOX 637783
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-7783
Mailing Address - Country:US
Mailing Address - Phone:513-853-4749
Mailing Address - Fax:513-853-4740
Practice Address - Street 1:3285 WESTBOURNE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-5130
Practice Address - Country:US
Practice Address - Phone:513-922-4810
Practice Address - Fax:513-922-3421
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35044750S207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
31114645900OtherBWC-OH
870726OtherWORKER'S COMP RISK NUMBER
OH0489421Medicaid
870726OtherWORKER'S COMP RISK NUMBER
A79531Medicare UPIN
OH0480093Medicare ID - Type Unspecified