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Individual

DR. TED F SHAUB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
75 ARCH ST STE 206, AKRON, OH 44304-1431
(330) 374-0009
(330) 374-5693
Mailing address
75 ARCH ST STE 206, AKRON, OH 44304-1431
(330) 374-0009
(330) 374-5693

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35050617S
OH
207RI0011X
Interventional Cardiology Physician
Primary
35050617S
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0626812
MEDICARE ID
OH
01
0626816
MEDICARE ID
OH
05
0651852
OH
Enumeration date
06/20/2005
Last updated
12/06/2012
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