Healthcare Provider Details

I. General information

NPI: 1275976342
Provider Name (Legal Business Name): ROHIT SHAH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 E RIVER ST
ELYRIA OH
44035-5902
US

IV. Provider business mailing address

13207 RAVENNA RD
CHARDON OH
44024-7032
US

V. Phone/Fax

Practice location:
  • Phone: 440-542-5000
  • Fax:
Mailing address:
  • Phone: 440-285-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number35.129252
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: