MEDICARE: SHASHI PUTTASWAMY MD

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	207R00000X	Internal Medicine Physician	01041820	IN

General Provider Information

NPI Number	:	1316055304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHASHI PUTTASWAMY MD

Provider Business Mailing Address
First Line	:	10330 N MERIDIAN ST # 300
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46290-1024
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13400 N MERIDIAN ST # 302
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46032-7102
Country	:	US
Telephone Number	:	317-415-6050
Fax Number	:

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	09/22/2016

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