MEDICARE: NASIR A SHAMSI, MD PC

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	208000000X	Pediatrics Physician	01043702	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	:	1578872057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NASIR A SHAMSI, MD PC

Provider Business Mailing Address
First Line	:	6933 KENNEDY AVE
Second Line	:
City	:	HAMMOND
State	:	IN
Zip	:	46323-2210
Country	:	US
Telephone Number	:	219-844-2256
Fax Number	:

Provider Business Practice Location Address
First Line	:	6933 KENNEDY AVE ST C
Second Line	:
City	:	HAMMOND
State	:	IN
Zip	:	46323-2210
Country	:	US
Telephone Number	:	219-844-2256
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	NASIR A SHAMSI
Credential	:	MD
Telephone Number	:	219-844-2256

Provider Enumeration Date	:	09/30/2010
Last Update Date	:	09/30/2010

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