Healthcare Provider Details

I. General information

NPI: 1114452703
Provider Name (Legal Business Name): JORDYN GABRIELLE SHAH DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JORDYN GABRIELLE SUHR

II. Dates (important events)

Enumeration Date: 04/21/2017
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CLEVELAND CLINIC 9500 EUCLID AVENUE/NA-23
CLEVELAND OH
44195-5000
US

IV. Provider business mailing address

CLEVELAND CLINIC 9500 EUCLID AVENUE/NA-23
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-444-2200
  • Fax:
Mailing address:
  • Phone: 216-444-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number34.016677
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: