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General NPI Number Information
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NPI Number | 1831327634
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Entity Type | Individual
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Provider Name | SHAUN ABDUL WAHAB M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2009
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 395 W 12TH AVE
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City | COLUMBUS
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State | OH
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Zip | 43210-1267
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Country | US
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Telephone | 614-293-8315
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Fax | 614-293-6935
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Provider Business Mailing Address
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Address Line | 700 ACKERMAN RD STE 2120
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City | COLUMBUS
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State | OH
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Zip | 43202-1559
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Country | US
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Telephone | 614-293-8315
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Fax | 614-293-6935
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 35.126566
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4301094276
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License Number State | MI
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