Individual
DHIRAJ SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
441 N WABASH AVE, MARION, IN 46952-2612
(765) 662-4236
(765) 662-4903
Mailing address
330 N WABASH AVE STE G-20, MARION, IN 46952-2605
(765) 660-7616
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01087976A
IN
208M00000X
Hospitalist Physician
01087976A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1102638432
ANTHEM
IN
Enumeration date
07/25/2019
Last updated
11/08/2022
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