Provider Demographics
NPI:1699087700
Name:RUNGTA, SHILPA (MD)
Entity type:Individual
Prefix:DR
First Name:SHILPA
Middle Name:
Last Name:RUNGTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12077 SHERATON LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-1611
Mailing Address - Country:US
Mailing Address - Phone:513-671-0093
Mailing Address - Fax:513-346-2724
Practice Address - Street 1:12077 SHERATON LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-1611
Practice Address - Country:US
Practice Address - Phone:513-671-0093
Practice Address - Fax:513-346-2724
Is Sole Proprietor?:No
Enumeration Date:2010-07-06
Last Update Date:2018-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301087759207ZC0500X, 207ZP0102X
OH35.122901207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology