Individual
SHABNAM MOSHREF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
8920 SOUTHPOINTE DR, SUITE B, INDIANAPOLIS, IN 46227-7509
(317) 497-1900
(317) 497-1919
Mailing address
6626 E. 75TH STREET, SUITE 500, INDIANAPOLIS, IN 46250-2890
(317) 497-6333
(317) 497-1919
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02004349A
IN
208D00000X
General Practice Physician
5101018943
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2010202340
—
IN
01
—
P01347725
MEDICARE RR PTAN
IN
Enumeration date
06/25/2010
Last updated
11/27/2023
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