| Bharat J Shah Md Inc | |
|
63 Baker Blvd Fairlawn OH 44333-3601 | |
| (330) 572-0641 | |
| (330) 572-0639 |
| Full Name | Bharat J Shah Md Inc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 63 Baker Blvd, Fairlawn, Ohio |
| Authorized Official Name and Position | Bharat J Shah (PRESIDENT) |
| Authorized Official Contact | 3305720641 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bharat J Shah Md Inc 63 Baker Blvd Fairlawn OH 44333-3601 Ph: (330) 572-0641 | Bharat J Shah Md Inc 63 Baker Blvd Fairlawn OH 44333-3601 Ph: (330) 572-0641 |
| NPI Number | 1396825675 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 5890696926 |
|---|---|
| Medicare Enrollment ID | O20040120000738 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396825675 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | 35051270 (Ohio) | Primary |
| Provider Name | Gayle M Maltarich |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124120209 PECOS PAC ID: 6709838741 Enrollment ID: I20050217000497 |
| Provider Name | Melissa A Mellinger |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1508034893 PECOS PAC ID: 7517044399 Enrollment ID: I20080403000070 |
| Provider Name | Bharat J Shah |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891771630 PECOS PAC ID: 5395646434 Enrollment ID: I20101013000055 |
| Provider Name | Aricka A Kesic-sellers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518395466 PECOS PAC ID: 1658504634 Enrollment ID: I20140428000828 |
| Provider Name | Maureen Sloan |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1861412660 PECOS PAC ID: 4981628591 Enrollment ID: I20141022001493 |
| Provider Name | Amanda K Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891192985 PECOS PAC ID: 4082930672 Enrollment ID: I20150225001187 |
| Provider Name | Nishi Jani Rajguru |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821577669 PECOS PAC ID: 6406107721 Enrollment ID: I20180926001987 |
| Provider Name | Tanya Lynn Whitmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164013843 PECOS PAC ID: 3375930258 Enrollment ID: I20220422001500 |
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