Individual
DR. LATA R SHUKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7220 E VIRGINIA ST, EVANSVILLE, IN 47715-4068
(812) 473-8986
(812) 471-6692
Mailing address
7220 E VIRGINIA ST, EVANSVILLE, IN 47715-4068
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01052377A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200319540
—
IN
Enumeration date
06/06/2006
Last updated
08/10/2022
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