Provider Demographics
NPI:1184831729
Name:SHAH, NINAD H (MD)
Entity Type:Individual
Prefix:
First Name:NINAD
Middle Name:H
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6626 E 75TH ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-2805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7950 N. SHADELAND AVENUE, SUITE 350
Practice Address - Street 2:GASTROENTEROLOGY ASSOCIATES, INC.
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-3098
Practice Address - Country:US
Practice Address - Phone:317-578-2600
Practice Address - Fax:317-578-6474
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH57.010802207R00000X
IN01069412A207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201024980Medicaid
INP01170037OtherRR MEDICARE PTAN
IN000000793615OtherANTHEM
INP01170037OtherRR MEDICARE PTAN