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Individual

KAMI C SHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
13430 N MERIDIAN ST, SUITE 275, CARMEL, IN 46032-1405
(317) 582-8810
(317) 582-8863
Mailing address
13430 N MERIDIAN ST, SUITE 275, CARMEL, IN 46032-1405
(317) 582-8810
(317) 582-8863

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10000476A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P01097929
RAILROAD MEDICARE PIN
IN
Enumeration date
06/25/2010
Last updated
12/14/2012
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