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General NPI Number Information
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NPI Number | 1073791034
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Entity Type | Organization
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Legal Business Name | SANJAY N SHAH MD INC
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Dates
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Enumeration Date | 02/01/2008
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Last Update Date | 02/01/2008
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Provider Practice Location Address
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Address Line | 847 BOULEVARD
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City | DOVER
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State | OH
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Zip | 44622
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Country | US
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Telephone | 330-343-1900
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Fax | 330-364-6891
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Provider Business Mailing Address
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Address Line | 847 BOULEVARD
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City | DOVER
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State | OH
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Zip | 44622
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Country | US
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Telephone | 330-343-1900
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Fax | 330-364-6891
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Authorized Official
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Title or Position | OWNER
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Name | DR. SANJAY N SHAH
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Credential | MD
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Telephone | 330-343-1900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 35037051
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License Number State | OH
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