Individual
NISHA SHAH KHERADIYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1931 BROWN ST, ANDERSON, IN 46016-4206
(765) 644-1225
Mailing address
1931 BROWN ST, ANDERSON, IN 46016-4206
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
01071573A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01071573A
MEDICAL LICENSE
IN
Enumeration date
04/06/2009
Last updated
07/11/2022
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