Basic Information
Provider Information
NPI: 1528387610
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHAH
FirstName: VEERAL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D., PHD.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3333 BURNET AVE
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber: 5136364200
FaxNumber:  
Practice Location
Address1: 3333 BURNET AVE
Address2:  
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber: 5136364200
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/28/2010
LastUpdateDate: 01/08/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/08/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207W00000XME112753FLN Allopathic & Osteopathic PhysiciansOphthalmology 
207WX0110X35.138320OHY    

No ID Information.


Home