Individual
SAMIR H SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1701 S CREASY LN, LAFAYETTE, IN 47905-4972
(765) 502-4000
(765) 502-4709
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01065714A
IN
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
01065714A
IN
207Q00000X
Family Medicine Physician
01065714A
IN
208M00000X
Hospitalist Physician
Primary
01065714A
IN
Other
Enumeration date
11/26/2007
Last updated
09/28/2023
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