Healthcare Provider Details

I. General information

NPI: 1861682916
Provider Name (Legal Business Name): ABHAY R SHELKE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2007
Last Update Date: 08/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3404 W SYLVANIA AVE
TOLEDO OH
43623-4467
US

IV. Provider business mailing address

2200 JEFFERSON AVE
TOLEDO OH
43604-7101
US

V. Phone/Fax

Practice location:
  • Phone: 419-517-1200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number35121941
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: