Individual
DR. SAMUEL SHIMON KHAIRKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1141 S INDIANA AVE, CROWN POINT, IN 46307-7205
(219) 662-0700
(219) 662-0973
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01074088A
IN
208000000X
Pediatrics Physician
036-137624
IL
208000000X
Pediatrics Physician
125.057740
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300017808
—
IN
Enumeration date
09/22/2011
Last updated
10/09/2023
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