Provider Demographics
NPI:1497793319
Name:SAHI, SHOBHA (MD)
Entity Type:Individual
Prefix:
First Name:SHOBHA
Middle Name:
Last Name:SAHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3201 MIDDLE ROAD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-4427
Mailing Address - Country:US
Mailing Address - Phone:812-372-8281
Mailing Address - Fax:812-378-4525
Practice Address - Street 1:3201 MIDDLE ROAD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47203-4427
Practice Address - Country:US
Practice Address - Phone:812-372-8281
Practice Address - Fax:812-372-4525
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01060758B207Q00000X
IN01060758A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200802250Medicaid
INM400029292Medicare PIN
INI45967Medicare UPIN
IN200802250Medicaid