DR. GAUTAM VINOD SHAH (NPI# 1265865034) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265865034 |
| Entity Type | Individual |
| Full Name | DR. GAUTAM VINOD SHAH |
| Credential | M.D |
| Practice Address |
20455 Lorain Rd Fl 2 Fairview Park OH 44126 |
| Mailing Address |
20455 Lorain Rd Fl 2 Fairview Park OH 44126-3530 |
| Practice Telephone | 2164081044 |
| Mailing Telephone | 2164081044 |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2019-07-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
35.136566 | OH | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| First Avenue At 16th Street, Cardiovascular Services Silver Building Room 4s09a, New York, NY 10003 | 2124202876 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831143676 | Gautam Motllal Shah | Internal Medicine | 10192 W. Coggins Drive, Sun City, AZ 85351-3405 | 2006-05-19 |
| 1063859502 | Gautam J Shah | Internal Medicine | 354 Santa Fe Dr, Encinitas, CA 92024-5142 | 2013-05-23 |
| 1942296157 | Gautam K Shah | Anesthesiology | 5454 Hohman Ave, Hammond, IN 46320-1931 | 2005-09-22 |
| Street Address |
20455 LORAIN RD FL 2 |
| City | FAIRVIEW PARK |
| State | OH |
| Zip Code | 44126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497072854 | Frederick Otieno Ochieng' | Internal Medicine | 20455 Lorain Rd Fl 2, Fairview Park, OH 44126-3530 | 2010-04-26 |
| 1992071161 | Roy Miler | Surgery | 20455 Lorain Rd Fl 2, Fairview Park, OH 44126-3530 | 2012-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164031506 | Robert Hutman Leathers | Home Health Aide | 22371 Lorain Road, Fairview Park, OH 44126 | 2020-07-30 |
| 1750916425 | Rachel Martin | Psychologist | 20800 Westgate Professional Center #200, Fairview Park, OH 44126 | 2020-03-03 |
| 1649810821 | John P Meehan | Counselor | 21139 Lorain Rd 12, Fairview, OH 44126 | 2020-01-15 |
| 1356856306 | Cynthia Takaht | Counselor | 20800 Westgate #200, Fairview Park, OH 44126 | 2017-12-12 |
| 1205383759 | Ashraf M.a Abushahin | Student in an Organized Health Care Education/Training Program | 20120 Lorain Raod, Apartment 602, Fairview Park, OH 44126 | 2016-09-01 |
| 1760853311 | Laveena A Meriga | Nurse Practitioner | 21358 Ellen Dr, Fairview Park, OH 44126 | 2015-10-08 |
| 1023425899 | Rafif Mousa | Obstetrics & Gynecology | 21500 Lorain Rd, Fairview Park, OH 44126 | 2014-07-14 |
| 1366878514 | Michael J Rudolph | Counselor | 20800 Westgate Prof Center, Suite 200, Fairview, OH 44126 | 2013-09-19 |
| 1336497924 | Dental 32 LLC | Dentist | 22640 Lorain Road, Fairview Park, OH 44126 | 2012-08-29 |
| 1871755660 | Varun Dixit | General Acute Care Hospital | 20120 Lorain Road, Apt 412, Fairview Park, OH 44126 | 2008-07-02 |
| Find all providers in zip 44126 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497072854 | Frederick Otieno Ochieng' | Internal Medicine | 20455 Lorain Rd Fl 2, Fairview Park, OH 44126-3530 | 2010-04-26 |
| 1689627689 | Tamouh Hamoud | Internal Medicine | 20455 Lorain Rd., Second Floor, Fairview Park, OH 44126 | 2006-05-18 |
| 1306805304 | Mohamed Bashar Mamlouk | Internal Medicine | 20455 Lorain Rd Ste 104b, Fairview Park, OH 44126-3529 | 2006-03-20 |
| 1689052227 | M Bashar Mamlouk Md Inc | Internal Medicine | 20455 Lorain Rd Ste 104b, Fairview Park, OH 44126-3529 | 2015-05-15 |
| 1376648683 | Cardiovascular Imaging Associates, LLC | Internal Medicine | 20997 Lorain Rd, Fairview Park, OH 44126-2030 | 2006-09-13 |
| 1124074364 | Anthony G. Vlastaris | Internal Medicine | 20455 Lorain Rd, Second Floor, Fairview Park, OH 44126-3494 | 2006-05-26 |
| 1003862335 | Marcello M. Mellino | Internal Medicine | 20455 Lorain Rd, Second Floor, Fairview Park, OH 44126-3494 | 2006-05-26 |
| 1457307787 | Sean V. Lyons | Internal Medicine | 20455 Lorain Rd, Second Floor, Fairview Park, OH 44126-3494 | 2006-05-26 |
| 1497708416 | Andrew J. Sakiewicz | Internal Medicine | 20455 Lorain Rd, Second Floor, Fairview Park, OH 44126-3494 | 2006-05-19 |
| 1922051937 | Emad Dean Nukta | Internal Medicine | 20455 Lorain Rd, Second Floor, Fairview Park, OH 44126-3494 | 2006-05-19 |
| Find all providers in FAIRVIEW PARK | ||||
| City | FAIRVIEW PARK |
| Zip Code | 44126 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.