# DR. ROGER SEBASTIAN SHINNERL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1760684765
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 01063822A | IN | — |
| 2086S0129X | Vascular Surgery Physician | 036166938 | IL | Yes |

## Other

- **Enumeration date:** 06/01/2007
- **Last updated:** 09/29/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00001666778 | BCBS | IN |
| 01 | — | 01063822A | STATE LICENSE | IN |
| 01 | — | 01063822B | STATE CSR | IN |
| 05 | — | 300063165 | — | IN |
| 05 | — | 7100035620 | — | KY |