Individual
SAMPURNA SHAKYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2422 LAKE AVE, ASHTABULA, OH 44004-4985
(440) 997-6980
(440) 994-7514
Mailing address
2422 LAKE AVE, ASHTABULA, OH 44004-4985
(440) 997-6980
(440) 994-7514
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35.139245
OH
Other
Enumeration date
04/06/2017
Last updated
08/19/2020
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