Individual
KHURRUM A SHAIKH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2520 E DUPONT RD, FORT WAYNE, IN 46825-1675
(260) 344-4035
(260) 969-9272
Mailing address
6435 W JEFFERSON BLVD, PMB 109, FORT WAYNE, IN 46804-6203
(260) 344-4035
(260) 969-9272
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01061057
IN
207R00000X
Internal Medicine Physician
35079807
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000547249
ANTHEM
IN
05
—
0064359
—
OH
01
—
079774180
CIGNA
IN
05
—
200826790
—
IN
01
—
20549
PHP
IN
Enumeration date
06/06/2006
Last updated
06/20/2016
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