Individual
TAREK H SHAHBANDAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8687 CONNECTICUT ST, STE D, MERRILLVILLE, IN 46410-5541
(219) 750-9630
(219) 750-9451
Mailing address
8687 CONNECTICUT ST, STE D, MERRILLVILLE, IN 46410-5541
(219) 750-9630
(219) 750-9451
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
01058916A
IN
208VP0014X
Interventional Pain Medicine Physician
01058916A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200489820A
—
IN
Enumeration date
07/14/2005
Last updated
09/30/2015
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