Individual
FRANK SHAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1720 BEACON ST, FORT WAYNE, IN 46805-4749
(260) 373-8000
(260) 373-8034
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01057139A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000543922
ANTHEM
IN
01
—
14436
PHYSICIANS HEALTH PLAN
IN
05
—
200431980
—
IN
05
—
2566094
—
OH
01
—
P00041676
RAILROAD MEDICARE
IN
01
—
P00466959
RAILROAD MEDICARE
IN
Enumeration date
01/11/2006
Last updated
10/17/2022
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