Provider Demographics
NPI:1750303640
Name:RANE, SHASHIKANT R (MD)
Entity Type:Individual
Prefix:DR
First Name:SHASHIKANT
Middle Name:R
Last Name:RANE
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 1:10 N MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-3252
Mailing Address - Country:US
Mailing Address - Phone:219-942-1131
Mailing Address - Fax:219-942-7903
Practice Address - Street 1:10 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:IN
Practice Address - Zip Code:46342-3252
Practice Address - Country:US
Practice Address - Phone:219-942-1131
Practice Address - Fax:219-942-7903
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031797207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100201540AMedicaid
IND15535Medicare UPIN
IN100201540AMedicaid