Idris, Syed Ali Shan

Idris, Syed Ali Shan is an sole proprietor health care provider with primary practice located at 5965 Easy Broad Street, Suite 260 , Columbus OH 43213. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Idris, Syed Ali Shan can be contacted via phone (641) 866-3703.

Contact Information

Primary practice address
5965 Easy Broad Street, Suite 260 Columbus OH 43213
Phone: (641) 866-3703
Fax: (614) 866-6109
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 35087057 Ohio
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35087057 Ohio
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 35.087057 Ohio
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 35.087057 Ohio
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35.087057 Ohio

Profile Details

NPI number 1942317060
LBN Legal business name Idris, Syed Ali Shan
Credentials M.D.; MBBS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 24th, 2006
Last updated Sep 8th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942317060 NPPES
Ohio MEDICAID 2697489
Ohio Other P00352662
Ohio Other 000000494609

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