Healthcare Provider Details

I. General information

NPI: 1043518244
Provider Name (Legal Business Name): SANA SHOAIB MEAH D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2011
Last Update Date: 01/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

761 45TH AVENUE SUITE 110
MUNSTER IN
46321-2899
US

IV. Provider business mailing address

1040 SIERRA DR STE 400
GREENWOOD IN
46143-7241
US

V. Phone/Fax

Practice location:
  • Phone: 219-922-3020
  • Fax: 219-922-3023
Mailing address:
  • Phone: 317-865-8540
  • Fax: 317-865-8317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number02004852A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: