Provider Demographics
NPI:1497384374
Name:SHAH, HAIDER HUSSAIN (MD)
Entity type:Individual
Prefix:
First Name:HAIDER
Middle Name:HUSSAIN
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4777 E. GALBRAITH ROAD, THE JEWISH HOSPITAL
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45236
Mailing Address - Country:US
Mailing Address - Phone:513-686-5446
Mailing Address - Fax:513-686-6868
Practice Address - Street 1:4777 E. GALBRAITH ROAD, THE JEWISH HOSPITAL
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45236
Practice Address - Country:US
Practice Address - Phone:513-686-5446
Practice Address - Fax:513-686-6868
Is Sole Proprietor?:No
Enumeration Date:2020-04-03
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0025379207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine