Individual
SHAWN FENOUGHTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 E MAIN ST, DANVILLE, IN 46122-1948
(317) 745-4451
(317) 745-8477
Mailing address
1100 SOUTHFIELD DR, SUITE 1370, PLAINFIELD, IN 46168-4498
(317) 837-5571
(317) 837-5580
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01056032A
IN
208M00000X
Hospitalist Physician
Primary
01056032A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100107650
—
IN
Enumeration date
09/15/2005
Last updated
04/01/2021
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