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General NPI Number Information
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NPI Number | 1710289293
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Entity Type | Organization
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Legal Business Name | PREMIER ALLERGY
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Dates
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Enumeration Date | 12/03/2010
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Last Update Date | 08/04/2014
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Provider Practice Location Address
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Address Line | 6565 PERIMETER DR
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City | DUBLIN
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State | OH
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Zip | 43016-8461
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Country | US
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Telephone | 614-328-9927
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Fax | 614-389-3727
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Provider Business Mailing Address
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Address Line | 6565 PERIMETER DR
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City | DUBLIN
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State | OH
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Zip | 43016-8461
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Country | US
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Telephone | 614-328-9927
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Fax | 614-389-3727
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | DR. SUMMIT S SHAH
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Credential | MD, FAAAAI
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Telephone | 614-328-9927
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 096318
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License Number State | OH
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