Individual
BAHADUR SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2015 JACKSON ST, ANDERSON, IN 46016
(765) 649-2511
Mailing address
250 W 96TH ST # 520, INDIANAPOLIS, IN 46260-1316
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01078604A
IN
207R00000X
Internal Medicine Physician
35-087325
OH
208M00000X
Hospitalist Physician
01078604A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2638006
—
OH
Enumeration date
08/17/2006
Last updated
02/04/2019
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