Individual
SHIVALLI DHARMENDRA RAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
901 SAINT MARYS DR STE 300, EVANSVILLE, IN 47714-0521
(812) 473-2642
Mailing address
901 SAINT MARYS DR, EVANSVILLE, IN 47714-0520
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10005089A
IN
Other
Enumeration date
09/25/2025
Last updated
11/20/2025
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