Basic Information
Provider Information
NPI: 1942589833
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SHAMSZAD
FirstName: PIROUZ
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3333 BURNET AVE
Address2: ML 5021
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3333 BURNET AVE
Address2: ML 2003
City: CINCINNATI
State: OH
PostalCode: 452293026
CountryCode: US
TelephoneNumber: 5136364432
FaxNumber: 5136363952
Other Information
ProviderEnumerationDate: 08/09/2011
LastUpdateDate: 10/03/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0202X35.098562OHY Allopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology

No ID Information.


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