Provider Demographics
NPI:1700896073
Name:SHAHID, AGHA (MD)
Entity type:Individual
Prefix:
First Name:AGHA
Middle Name:
Last Name:SHAHID
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 1:2741 NAVARRE AVE
Mailing Address - Street 2:SUITE D404
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3278
Mailing Address - Country:US
Mailing Address - Phone:419-698-2902
Mailing Address - Fax:419-698-3619
Practice Address - Street 1:2741 NAVARRE AVE
Practice Address - Street 2:SUITE D404
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3278
Practice Address - Country:US
Practice Address - Phone:419-698-2902
Practice Address - Fax:419-698-3619
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH420052084A0401X, 2084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0131052OtherANTHEM
OH0410451Medicaid
OH058458000OtherMAGELLAN HEALTH CARE
OH4212106OtherAETNA
791263581AOtherPALMETTO GBA RAILROAD MEDICARE
OH01375OtherPARAMOUNT HEALTH CARE
OH159644OtherPREFERRED HEALTH CARE SYS
OH662549OtherCIGNA
OH159644OtherPREFERRED HEALTH CARE SYS
OHA79100Medicare UPIN