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General NPI Number Information
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NPI Number | 1396275236
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Entity Type | Individual
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Provider Name | RUPAL SHASTRI MD
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Gender | Female
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Dates
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Enumeration Date | 06/13/2017
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Last Update Date | 09/09/2022
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE FL 5
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City | CLEVELAND
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State | OH
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Zip | 44195-3833
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Country | US
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Telephone | 216-444-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 1653 W CONGRESS PKWY
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City | CHICAGO
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State | IL
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Zip | 60612-3833
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Country | US
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Telephone | 312-942-5000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 35.146427
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License Number State | OH
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