Healthcare Provider Details

I. General information

NPI: 1578662425
Provider Name (Legal Business Name): SHAHIN F. SHAREEF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7665 MONARCH CT SUITE 104/105
WEST CHESTER OH
45069-2497
US

IV. Provider business mailing address

7665 MONARCH CT SUITE 104/105
WEST CHESTER OH
45069-2497
US

V. Phone/Fax

Practice location:
  • Phone: 513-779-4006
  • Fax: 513-779-7018
Mailing address:
  • Phone: 513-779-4006
  • Fax: 513-779-7018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35-071938
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: