Individual
DR. HAIDER RAZA SHAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 E COUNTY LINE RD, SUITE 101, GREENWOOD, IN 46143-1072
(317) 885-2860
(317) 885-2869
Mailing address
701 E COUNTY LINE RD, SUITE 101, GREENWOOD, IN 46143-1070
(317) 885-2860
(317) 885-2869
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01068115A
IN
208M00000X
Hospitalist Physician
Primary
01068115A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200985130
—
IN
Enumeration date
04/23/2010
Last updated
01/14/2022
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