Individual
MR. SHAHEEN PARVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1640 45TH ST, MUNSTER, IN 46321
(219) 513-0999
Mailing address
1640 45TH ST, MUNSTER, IN 46321
(219) 513-0999
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01039726A
IN
207R00000X
Internal Medicine Physician
Primary
01039726A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000278480
ANTHEM BCBS
IN
01
—
01039726A
LICENSE IN
IN
05
—
036082858
—
IN
05
—
100047375013B
—
IN
05
—
100473750
—
IN
01
—
200257526
TAX ID
IN
01
—
90001082
BCBS
IL
01
—
930128582
MEDICARE RAILROAD
IN
Enumeration date
01/24/2006
Last updated
09/07/2016
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