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Organization

SHIMUL Y SHAH

Active
Other names
Marysville Family Vision
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHIMUL Y SHAH O.D. (OWNER/OPTOMETRIST)
(937) 642-1300
Entity
Organization

Contact information

Practice address
122 N MAIN ST, MARYSVILLE, OH 43040-1106
(937) 642-1300
(937) 642-0101
Mailing address
122 N MAIN ST, MARYSVILLE, OH 43040-1106
(937) 642-1300
(937) 642-0101

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
5091
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1043254170
INDIVIDUAL NPI
OH
05
2636099
OH
Enumeration date
01/03/2008
Last updated
06/04/2013
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