Provider Demographics
NPI:1134181613
Name:LAKHANI, SHANKAR (MD)
Entity type:Individual
Prefix:
First Name:SHANKAR
Middle Name:
Last Name:LAKHANI
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 1:200 BANNING ST STE 280
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3489
Mailing Address - Country:US
Mailing Address - Phone:302-734-4434
Mailing Address - Fax:
Practice Address - Street 1:200 BANNING ST STE 280
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3489
Practice Address - Country:US
Practice Address - Phone:302-734-4434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DECI0006683207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000033362Medicaid
DE018155P62Medicare ID - Type Unspecified
DE1000033362Medicaid