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Individual

KETAN S. SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3120 GOVERNORS PLACE BLVD, DAYTON, OH 45409-1328
(937) 293-1622
(937) 245-6308
Mailing address
6680 POE AVE STE 200, DAYTON, OH 45414-2855
(937) 280-8400
(937) 280-8373

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
35061874
OH
207RH0003X
Hematology & Oncology Physician
35061874-S
OH
207RX0202X
Medical Oncology Physician
35.061874
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0824666
OH
Enumeration date
05/11/2006
Last updated
01/07/2022
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