Healthcare Provider Details

I. General information

NPI: 1235321738
Provider Name (Legal Business Name): SHEFALI A KAPADIA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 03/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11500 HIGHWAY 62
CHARLESTOWN IN
47111-8612
US

IV. Provider business mailing address

11500 HIGHWAY 62
CHARLESTOWN IN
47111-8612
US

V. Phone/Fax

Practice location:
  • Phone: 812-256-0700
  • Fax: 812-256-0704
Mailing address:
  • Phone: 812-256-0700
  • Fax: 812-256-0704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01064474A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberMD431287
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number41640
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number01064474A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: