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Individual

DR. MAHENDRA M SHAH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
8554 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 750-9581
(219) 750-9781
Mailing address
715 DR MARTIN LUTHER KING JR AVE NE STE 102, ALBUQUERQUE, NM 87102-3666
(505) 727-3040
(505) 727-3099

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
01029974
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100202010A
IN
05
82879257
NM
Enumeration date
05/18/2006
Last updated
03/05/2019
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