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1184606022

NPI Code Detail

MEDICARE: DR. SHAUKAT IFTIKHAR M.D.

MEDICARE: DR. SHAUKAT IFTIKHAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	200000468	NC
2	207RG0100X	Gastroenterology Physician	01071136A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	P00442382	OTHER	NC	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0191F	OTHER	NC	NCBC GROUP
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	137WO	OTHER	NC	BCBS NC
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184606022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAUKAT IFTIKHAR M.D.

Provider Business Mailing Address
First Line	:	PO BOX 1510
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47706-1510
Country	:	US
Telephone Number	:	812-450-6815
Fax Number	:	812-858-4512

Provider Business Practice Location Address
First Line	:	421 CHESTNUT ST
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47713-1227
Country	:	US
Telephone Number	:	812-426-9454
Fax Number	:	812-858-4512

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	03/17/2018

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Directions to “ DR. SHAUKAT IFTIKHAR M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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