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General NPI Number Information
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NPI Number | 1568708428
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Entity Type | Individual
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Provider Name | FOWAD SHAHZAD MD
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Gender | Male
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Dates
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Enumeration Date | 12/21/2012
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 11109 PARKVIEW PLAZA DR
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City | FORT WAYNE
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State | IN
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Zip | 46845-1701
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Country | US
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Telephone | 260-266-2020
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Fax | 260-266-2009
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Provider Business Mailing Address
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Address Line | 2450 W HUNTING PARK AVE 3RD FLOOR
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City | PHILADELPHIA
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State | PA
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Zip | 19129-1302
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Country | US
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Telephone | 215-707-2433
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Fax | 215-707-3677
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C175555
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD207767
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 01082951A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD449023
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01082951A
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License Number State | IN
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