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Individual

DR. JAY SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
800 INDIAN BOUNDARY RD, CHESTERTON, IN 46304-1695
(872) 317-0501
(872) 317-0500
Mailing address
10855 VIRGINIA ST, CROWN POINT, IN 46307-0210
(872) 317-0501
(872) 317-0500

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125052454
IL
207RC0000X
Cardiovascular Disease Physician
Primary
01072775A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201183930
IN
Enumeration date
01/21/2010
Last updated
12/22/2025
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