Individual
MUKUND K SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 MATTHEW ST, STRECKER CANCER CENTER, MARIETTA, OH 45750-1644
(740) 376-5000
(740) 376-5002
Mailing address
PO BOX 449, MARIETTA, OH 45750-0449
(740) 374-4500
(740) 374-5887
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
13835
WV
207RH0003X
Hematology & Oncology Physician
Primary
35050858
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000525667
ANTHEM
OH
01
—
000000696927
ANTHEM
OH
05
—
0085338000
—
WV
05
—
0549213
—
OH
01
—
P00997169
RRMCR
OH
Enumeration date
09/12/2006
Last updated
08/02/2021
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