Healthcare Provider Details

I. General information

NPI: 1174526347
Provider Name (Legal Business Name): ARVIND B SHAH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 04/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

# L-3539
COLUMBUS OH
43260-0001
US

IV. Provider business mailing address

# L-3539
COLUMBUS OH
43260-0001
US

V. Phone/Fax

Practice location:
  • Phone: 304-414-4800
  • Fax: 304-414-4801
Mailing address:
  • Phone: 304-414-4800
  • Fax: 304-414-4801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number13593
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: