Individual
DR. SHABANA SHAHANAVAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3333 BURNET AVE, MLC 2003, CINCINNATI, OH 45229-3026
(513) 636-4432
(513) 636-3952
Mailing address
1 CHILDRENS PL, NWT 8328 CB 8116, SAINT LOUIS, MO 63110-1002
(314) 454-6095
(314) 454-2561
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
01092178A
IN
2080P0202X
Pediatric Cardiology Physician
2011031514
MO
2080P0202X
Pediatric Cardiology Physician
Primary
35.140161
OH
2080P0202X
Pediatric Cardiology Physician
54308
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811229107
—
MO
05
—
ENROLLED
—
IL
Enumeration date
02/11/2010
Last updated
03/26/2024
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