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General NPI Number Information
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NPI Number | 1255407045
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Entity Type | Individual
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Provider Name | MICHAEL SAMUEL SHRIFT MD
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Gender | Male
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Dates
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Enumeration Date | 11/26/2006
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 697 PRO MED LN
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City | CARMEL
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State | IN
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Zip | 46032-5323
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Country | US
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Telephone | 317-574-1254
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Fax | 317-674-0060
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Provider Business Mailing Address
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Address Line | 303 CONGRESSIONAL BLVD
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City | CARMEL
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State | IN
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Zip | 46032-5631
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Country | US
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Telephone | 612-305-8247
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 51443
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 31036
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 01074131A
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License Number State | IN
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