Individual
DR. ANIL R SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9800 VALPARAISO DR, MUNSTER, IN 46321-4040
(219) 934-5800
Mailing address
757 45TH AVE, STE. 201, MUNSTER, IN 46321-2911
(219) 934-2461
(219) 934-2478
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
01066901A
IN
207Y00000X
Otolaryngology Physician
235640
NY
207YS0123X
Facial Plastic Surgery Physician
036120006
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200948380
—
IN
01
—
235640
NYS LICENSE#
NY
Enumeration date
07/17/2006
Last updated
06/08/2015
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