Individual
SHASHANK NUGURU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
550 UNIVERSITY BLVD, UH 1501, INDIANAPOLIS, IN 46202-5149
(317) 948-1310
(317) 948-0503
Mailing address
120 STONEBRIDGE PKWY STE 320, WOODSTOCK, GA 30189-3769
(770) 422-1372
(770) 423-9651
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01075577A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
90273
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201309900
—
IN
Enumeration date
10/23/2012
Last updated
01/03/2022
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