Individual
LAUREN ROSE SHADIOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1001 N MADISON AVE, GREENWOOD, IN 46142-4135
(317) 528-7500
(317) 528-7515
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002495A
IN
Other
Enumeration date
08/07/2018
Last updated
09/18/2023
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