MEDICARE: NEHA NARENDRA SHAH D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	2084P0800X	Psychiatry Physician	34011054	OH

General Provider Information

NPI Number	:	1043509979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEHA NARENDRA SHAH D.O.

Provider Business Mailing Address
First Line	:	2720 AIRPORT DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-2219
Country	:	US
Telephone Number	:	614-388-7650
Fax Number	:

Provider Business Practice Location Address
First Line	:	2720 AIRPORT DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43219-2219
Country	:	US
Telephone Number	:	614-388-7650
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2011
Last Update Date	:	04/26/2017

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