Healthcare Provider Details

I. General information

NPI: 1497793319
Provider Name (Legal Business Name): SHOBHA SAHI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 11/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 MIDDLE ROAD
COLUMBUS IN
47203-4427
US

IV. Provider business mailing address

3201 MIDDLE ROAD
COLUMBUS IN
47203-4427
US

V. Phone/Fax

Practice location:
  • Phone: 812-372-8281
  • Fax: 812-372-4525
Mailing address:
  • Phone: 812-372-8281
  • Fax: 812-378-4525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01060758B
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01060758A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: