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Individual

DR. JAY RAJENDRA SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-6000
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
35.121069
OH
207YP0228X
Pediatric Otolaryngology Physician
Primary
35.121069
OH
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0086146
OH
Enumeration date
10/11/2007
Last updated
09/04/2013
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