Healthcare Provider Details

I. General information

NPI: 1578692489
Provider Name (Legal Business Name): HEMAL SHAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10506A MONTGOMERY RD STE 301
CINCINNATI OH
45242-4400
US

IV. Provider business mailing address

10506A MONTGOMERY RD STE 301
CINCINNATI OH
45242-4400
US

V. Phone/Fax

Practice location:
  • Phone: 513-246-2400
  • Fax: 513-985-2905
Mailing address:
  • Phone: 513-246-2400
  • Fax: 513-985-2905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number35.120153
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: