Individual
KEIVAN SHALILEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5165 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 448-8000
(765) 448-7631
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01088344A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
01088344A
IN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
036-150264
IL
207RP1001X
Pulmonary Disease Physician
01088344A
IN
207RP1001X
Pulmonary Disease Physician
125069881
IL
Other
Enumeration date
01/20/2015
Last updated
11/03/2022
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