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General NPI Number Information
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NPI Number | 1679063382
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Entity Type | Individual
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Provider Name | SHALINI BAIJAL
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Gender | Female
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Dates
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Enumeration Date | 05/17/2018
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Last Update Date | 05/17/2018
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Provider Practice Location Address
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Address Line | 801 E WASHINGTON ST STE 150
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City | MEDINA
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State | OH
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Zip | 44256-3336
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Country | US
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Telephone | 330-722-1069
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Fax |
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Provider Business Mailing Address
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Address Line | 9377 SAGAMORE CIR
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City | STRONGSVILLE
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State | OH
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Zip | 44136-8839
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Country | US
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Telephone | 248-565-6488
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 50.005560RX
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License Number State | OH
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