MEDICARE: DR. PAUL P SHU 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	2085R0202X	Diagnostic Radiology Physician	01060027A	IN
2	2085N0700X	Neuroradiology Physician	01060027A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	959090180	OTHER	IN	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720031727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAUL P SHU MD

Provider Business Mailing Address
First Line	:	250 N SHADELAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46219-4959
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	714 N SENATE AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46202-3763
Country	:	US
Telephone Number	:	317-963-0166
Fax Number	:	317-963-2711

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	05/03/2023

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Directions to “ DR. PAUL P SHU MD” Practice Location

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