MEDICARE: KAREN T. SHIRRELL, MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	01036141	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770914574
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAREN T. SHIRRELL, MD

Provider Business Mailing Address
First Line	:	1427 W 86TH ST
Second Line	:	SUITE #152
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-2103
Country	:	US
Telephone Number	:	317-889-0635
Fax Number	:

Provider Business Practice Location Address
First Line	:	1427 W 86TH ST
Second Line	:	SUITE #152
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-2103
Country	:	US
Telephone Number	:	317-889-0635
Fax Number	:	317-889-0635

Authorized Official
Title or Position	:	OWNER
Name	:	DR. KAREN T SHIRRELL
Credential	:	M.D.
Telephone Number	:	317-257-2076

Provider Enumeration Date	:	12/03/2013
Last Update Date	:	12/12/2016

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