Healthcare Provider Details

I. General information

NPI: 1013231588
Provider Name (Legal Business Name): AKEESHA A SHAH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2010
Last Update Date: 08/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE L25
CLEVELAND OH
44193-1913
US

IV. Provider business mailing address

9500 EUCLID AVE L25
CLEVELAND OH
44193-1913
US

V. Phone/Fax

Practice location:
  • Phone: 216-636-9407
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License Number127961
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number127961
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: