MEDICARE: DR. BRIAN MATHEW SHIFF M.D.

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	208600000X	Surgery Physician	35074200	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851378301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN MATHEW SHIFF M.D.

Provider Business Mailing Address
First Line	:	2055 HOSPITAL DR
Second Line	:	STE. 355
City	:	BATAVIA
State	:	OH
Zip	:	45103-1978
Country	:	US
Telephone Number	:	513-732-9300
Fax Number	:	513-732-5663

Provider Business Practice Location Address
First Line	:	2055 HOSPITAL DR
Second Line	:	STE. 355
City	:	BATAVIA
State	:	OH
Zip	:	45103-1978
Country	:	US
Telephone Number	:	513-732-9300
Fax Number	:	513-732-5663

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

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	09/17/2014

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