Individual
CHITTARANJAN JAYSHANKER SHUKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2720 AIRPORT DR, COLUMBUS, OH 43219-2219
(614) 388-7650
(614) 473-3789
Mailing address
2720 AIRPORT DR, COLUMBUS, OH 43219-2219
(614) 388-7650
(614) 473-3789
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
34405
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0256
MEDICARE
KY
01
—
610661458
GROUP TAX ID
KY
Enumeration date
05/03/2006
Last updated
09/28/2018
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