Provider Demographics
NPI:1770693335
Name:SHINHAR, SHAI YESHAJAHU (MD)
Entity type:Individual
Prefix:DR
First Name:SHAI
Middle Name:YESHAJAHU
Last Name:SHINHAR
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 1:605 3RD AVE STE A
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:OH
Mailing Address - Zip Code:43420-3269
Mailing Address - Country:US
Mailing Address - Phone:419-332-2803
Mailing Address - Fax:419-332-2823
Practice Address - Street 1:605 3RD AVE STE A
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:OH
Practice Address - Zip Code:43420-3269
Practice Address - Country:US
Practice Address - Phone:419-332-2803
Practice Address - Fax:419-332-2823
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350837655207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2461009Medicaid
OH4126651Medicare ID - Type Unspecified
OHI01033Medicare UPIN