Individual
DR. SHAHED TISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2020013288
MO
208600000X
Surgery Physician
Primary
35.156237
OH
208600000X
Surgery Physician
79527
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020013288
MO LICENSE
MO
01
—
35.156237
LICENSE
OH
Enumeration date
06/25/2019
Last updated
06/05/2026
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