Individual
DR. SHAUN SADRUDDIN MEHDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
6200 CENTRAL AVE, PORTAGE, IN 46368-3702
(219) 762-1040
(219) 762-1041
Mailing address
2022 KELLE DR, CHESTERTON, IN 46304-8708
(219) 364-3616
(219) 364-3610
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
02005976A
IN
207R00000X
Internal Medicine Physician
125071534
IL
Other
Enumeration date
07/03/2017
Last updated
07/21/2022
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