Individual
SHADIA I JALAL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
535 BARNHILL DR, INDIANAPOLIS, IN 46202-5112
(317) 274-5500
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
11011496A
IN
207R00000X
Internal Medicine Physician
01066389A
IN
207RH0003X
Hematology & Oncology Physician
Primary
01066389A
IN
207RX0202X
Medical Oncology Physician
01066389A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000616937
ANTHEM PTAN
IN
05
—
200940570
—
IN
Enumeration date
07/10/2008
Last updated
03/11/2025
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