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General NPI Number Information
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NPI Number | 1235929084
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Entity Type | Individual
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Provider Name | SHUMILA KAZMI
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Gender | Female
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 3746 NATIONAL RD E
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City | RICHMOND
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State | IN
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Zip | 47374-3643
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Country | US
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Telephone | 765-966-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 6317 COLTON RIDGE CT
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City | PLAINFIELD
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State | IL
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Zip | 60586-5633
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Country | US
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Telephone | 815-995-1675
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12014752A
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License Number State | IN
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