Provider Demographics
NPI:1770529067
Name:SHAY, BRIAN F (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:F
Last Name:SHAY
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 1:2000 JOSEPH E SANKER BLVD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45212-1979
Mailing Address - Country:US
Mailing Address - Phone:513-841-7400
Mailing Address - Fax:513-841-7402
Practice Address - Street 1:350 THOMAS MORE PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:CRESTVIEW HILLS
Practice Address - State:KY
Practice Address - Zip Code:41017-5465
Practice Address - Country:US
Practice Address - Phone:859-363-2200
Practice Address - Fax:859-363-2201
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2013-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-08-3152208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0276946Medicaid
OHP00466932OtherRAILROAD MEDICARE
IN200091770AMedicaid
OH2468191Medicaid
KYP00088917OtherRAILROAD MEDICARE
IN611257391028Medicaid
KY64077845Medicaid
IN285070Medicaid
OHP00466932OtherRAILROAD MEDICARE
IN200091770AMedicaid
OH2468191Medicaid
OH9284399Medicare PIN
KYP00088917OtherRAILROAD MEDICARE
OH0276946Medicaid
KY64077845Medicaid