Basic Information
| Provider Information | |||||||||
| NPI: | 1932355955 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHAFTEL | ||||||||
| FirstName: | NOAH | ||||||||
| MiddleName: | DANIEL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11140 MONTGOMERY RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452492309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132215500 | ||||||||
| FaxNumber: | 5132211962 | ||||||||
| Practice Location | |||||||||
| Address1: | 11140 MONTGOMERY RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452492309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132215500 | ||||||||
| FaxNumber: | 5132211962 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2008 | ||||||||
| LastUpdateDate: | 10/23/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/23/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0105X | 35.121299 | OH | Y | Allopathic & Osteopathic Physicians | Surgery | Surgery of the Hand |
ID Information
| ID | Type | State | Issuer | Description | 7100262100 | 05 | KY | MEDICAID | 0090859 | 05 | OH | MEDICAID |