MEDICARE: DR. SHASHI K AHUJA 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	207RC0000X	Cardiovascular Disease Physician	01027373A	IN

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

General Provider Information

NPI Number	:	1548379191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHASHI K AHUJA M.D.

Provider Business Mailing Address
First Line	:	800 BROADWAY STE 300
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46802-2149
Country	:	US
Telephone Number	:	260-425-3133
Fax Number	:	260-425-3110

Provider Business Practice Location Address
First Line	:	800 BROADWAY
Second Line	:	SUITE 300
City	:	FORT WAYNE
State	:	IN
Zip	:	46802-2149
Country	:	US
Telephone Number	:	260-425-3133
Fax Number	:	260-425-3110

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	12/04/2009

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Directions to “ DR. SHASHI K AHUJA M.D.” Practice Location

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