Individual
DR. SHEELA DEIVANAYAGAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD., DCH., MRCPCH
Contact information
Practice address
8402 HARCOURT RD STE 402, INDIANAPOLIS, IN 46260-2053
(317) 338-9450
Mailing address
8402 HARCOURT RD STE 402, INDIANAPOLIS, IN 46260-2053
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01069014A
IN
2080P0206X
Pediatric Gastroenterology Physician
Primary
01069014A
IN
2080P0206X
Pediatric Gastroenterology Physician
2001012033
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036118394
—
IL
Enumeration date
03/28/2007
Last updated
06/17/2022
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