Individual
MOUSUMEE SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 CHILDRENS PLZ, DAYTON, OH 45404-1815
(937) 641-3000
(937) 641-3107
Mailing address
PO BOX 933432, CLEVELAND, OH 44193-0039
(937) 641-5072
(919) 843-7036
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
192323
NC
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
35.137318
OH
390200000X
Student in an Organized Health Care Education/Training Program
192323
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0366519
—
OH
Enumeration date
06/04/2013
Last updated
10/13/2023
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