Healthcare Provider Details

I. General information

NPI: 1588981518
Provider Name (Legal Business Name): ANSHU SHUKLA M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2010
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5400 KENNEDY AVE STE 1
CINCINNATI OH
45213-2668
US

IV. Provider business mailing address

5400 KENNEDY AVE STE 1
CINCINNATI OH
45213-2668
US

V. Phone/Fax

Practice location:
  • Phone: 513-281-3400
  • Fax:
Mailing address:
  • Phone: 513-281-3400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberM-2154
License Number StateGU
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number35.133360
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number0101259968
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD223904
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: