Healthcare Provider Details

I. General information

NPI: 1952097263
Provider Name (Legal Business Name): MANAN MUNIRKRUTI SHAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2023
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E MARKET ST
AKRON OH
44304-1619
US

IV. Provider business mailing address

55 ARCH ST
AKRON OH
44304-1423
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-3315
  • Fax:
Mailing address:
  • Phone: 330-375-3315
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number97737
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: