Individual
SHAUN MADAHAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 E CHESTNUT ST, SERVICE BUILDING SUITE 303, LOUISVILLE, KY 40202-1831
(502) 629-5552
(502) 629-3132
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 272-5754
(502) 272-5339
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101254825
VA
207R00000X
Internal Medicine Physician
127851
CA
207R00000X
Internal Medicine Physician
Primary
46502
KY
208M00000X
Hospitalist Physician
01076265A
IN
208M00000X
Hospitalist Physician
MD454367
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100263820
—
KY
Enumeration date
01/28/2011
Last updated
07/21/2022
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