Organization
EMGI CLARIAN WEST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES SHUFFLEBARGER MD (PRESIDENT)
(317) 802-3146
Entity
Organization
Contact information
Practice address
1111 RONALD REAGAN PKWY, AVON, IN 46123-7085
(317) 802-3146
Mailing address
2449 RELIABLE PARKWAY, CHICAGO, IL 60686-0001
(317) 802-3146
(317) 870-0499
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200492410A
—
IN
Enumeration date
06/12/2006
Last updated
02/28/2011
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