Raju S Shah, M.D.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

35-03-6372-S Issued in OH

Practice address

5705 Monclova Rd
Suite 203
Maumee, OH 43537-1875

Phone

(419) 893-2622

NPI assigned

Aug 2, 2005

Reactivated

Mar 28, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1023019882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5705 MONCLOVA RD",
            "address_2": "SUITE 203",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371875",
            "telephone_number": "419-893-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5705 MONCLOVA RD",
            "address_2": "SUITE 203",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435371875",
            "telephone_number": "419-893-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAH",
        "first_name": "RAJU",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2026-07-13",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "OH",
            "license": "35-03-6372-S",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0392632",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kelly Ann Shank, NP
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• Brittany L Sheaves, RN

• Colon & Rectal Surgery Physician in Maumee, OH
• Providers in Maumee, OH by specialty
• Colon & Rectal Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.