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General NPI Number Information
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NPI Number | 1932514999
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Entity Type | Individual
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Provider Name | ALAA SHAMMAH M.D
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Gender | Male
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Dates
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Enumeration Date | 06/27/2014
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Last Update Date | 08/20/2024
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Provider Practice Location Address
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Address Line | 8501 E 56TH ST STE 120
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City | INDIANAPOLIS
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State | IN
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Zip | 46216-2118
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Country | US
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Telephone | 317-621-3700
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Fax |
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Provider Business Mailing Address
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Address Line | 6626 E 75TH ST STE 500
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City | INDIANAPOLIS
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State | IN
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Zip | 46250-2890
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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 |
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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 | 125.064360
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License Number State | IL
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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 | 01078391A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 01078391A
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License Number State | IN
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