MEDICARE: CHANDRESHKUMAR S SHAH MD

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	174400000X	Specialist	036-097084	IL
2	207L00000X	Anesthesiology Physician	201476	NY
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	35094830	OH
4	207L00000X	Anesthesiology Physician	35094830	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1378829	OTHER	IL	UNITED HEALTHCARE #

General Provider Information

NPI Number	:	1437154234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHANDRESHKUMAR S SHAH MD

Provider Business Mailing Address
First Line	:	2139 AUBURN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2906
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2139 AUBURN AVE
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-2906
Country	:	US
Telephone Number	:	513-369-2000
Fax Number	:

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	08/06/2025

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Directions to “ CHANDRESHKUMAR S SHAH MD” Practice Location

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