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NPI Code Detail

MEDICARE: PANKAJ D SHAH MD

MEDICARE:   PANKAJ D 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
1207L00000XAnesthesiology Physician35044144OH
2207LA0401XAddiction Medicine (Anesthesiology) Physician35044144OH
3207LC0200XCritical Care Medicine (Anesthesiology) Physician35044144OH
4207LH0002XHospice and Palliative Medicine (Anesthesiology) Physician35044144OH
5207LP2900XPain Medicine (Anesthesiology) Physician35044144OH
6207LP3000XPediatric Anesthesiology Physician35044144OH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
7P00929255OTHEROHMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10583328OTHEROHBCMH
2000000221333OTHEROHUNISON
3000000516062OTHEROHANTHEM
44007903OTHEROHAETNA
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
8MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518969559
Entity Type Code : Individual
Provider Name (Legal Business Name) : PANKAJ D SHAH MD
Provider Business Mailing Address
First Line : 24701 EUCLID AVE
Second Line : 3RD FLOOR
City : EUCLID
State : OH
Zip : 44117-1714
Country : US
Telephone Number : 216-383-6614
Fax Number :
Provider Business Practice Location Address
First Line : 11100 EUCLID AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44106
Country : US
Telephone Number : 216-844-7330
Fax Number : 216-844-3781
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2005
Last Update Date : 06/30/2011

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