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Individual

JITENDRA SAH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11109 PARKVIEW PLAZA DR., FORT WAYNE, IN 46845-1707
(260) 672-6620
(260) 672-6639
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01070764A
IN
207R00000X
Internal Medicine Physician
4301092336
MI
208M00000X
Hospitalist Physician
01070764A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000762679
ANTHEM
IN
05
201058600
IN
01
P01071809
R.R. MEDICARE
IN
Enumeration date
07/17/2008
Last updated
10/20/2022
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