Organization
SURENDRA J SHAH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SURENDRA J SHAH M.D. (OWNER)
(219) 884-1400
Entity
Organization
Contact information
Practice address
5825 BROADWAY, SUITE A, MERRILLVILLE, IN 46410-2687
(219) 884-1400
(219) 884-1453
Mailing address
5825 BROADWAY, SUITE A, MERRILLVILLE, IN 46410-2687
(219) 884-1400
(219) 884-1453
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
01032180A
IN
Other
Enumeration date
11/01/2007
Last updated
12/18/2007
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