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Individual

SHIVANG SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5330 E STOP 11 RD, INDIANAPOLIS, IN 46237-6345
(317) 893-1900
(317) 893-1901
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT197941
PA
207RC0000X
Cardiovascular Disease Physician
01080644A
IN
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
01080644A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300017674
IN
Enumeration date
06/25/2010
Last updated
09/29/2023
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