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Individual

DR. SHEETHU SADASIVAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1115 N RONALD REAGAN PKWY, STE 206, AVON, IN 46123-6911
(317) 217-2888
(317) 217-2999
Mailing address
250 N SHADELAND AVE, STE 130 - PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01071884A
IN
208M00000X
Hospitalist Physician
MD170350
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1891981304
VA MEDICAID
VA
05
201121360
IN
Enumeration date
09/18/2007
Last updated
06/11/2025
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