Healthcare Provider Details

I. General information

NPI: 1871306910
Provider Name (Legal Business Name): DR. ASSURANCE NSHOM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 E MAIN ST
PLAINFIELD IN
46168-1849
US

IV. Provider business mailing address

1885 TARTAN LN APT 302
AVON IN
46123-4218
US

V. Phone/Fax

Practice location:
  • Phone: 317-839-6822
  • Fax:
Mailing address:
  • Phone: 301-379-4273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26029562A
License Number StateIN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: