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General NPI Number Information
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NPI Number | 1851188114
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Entity Type | Organization
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Legal Business Name | NORTHWEST INDIANA RETINA INSTITUTE LLC
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 8895 BROADWAY
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City | MERRILLVILLE
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State | IN
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Zip | 46410-7037
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Country | US
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Telephone | 219-259-1760
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Fax | 219-259-1767
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Provider Business Mailing Address
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Address Line | 10307 MARLOU DR
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City | MUNSTER
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State | IN
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Zip | 46321-4339
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | AADITYA SHAH
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Credential | MD
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Telephone | 219-259-1760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0107X
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Taxonomy Name | Retina Specialist (Ophthalmology) Physician
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License Number |
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License Number State |
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