Provider Demographics
NPI:1134416977
Name:NAGARKATTI, SUSHRUTA SHANTANU (MBBS)
Entity type:Individual
Prefix:DR
First Name:SUSHRUTA
Middle Name:SHANTANU
Last Name:NAGARKATTI
Suffix:
Gender:M
Credentials:MBBS
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Mailing Address - Street 1:5215 HOLY CROSS PKWY
Mailing Address - Street 2:
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-1469
Mailing Address - Country:US
Mailing Address - Phone:574-335-8707
Mailing Address - Fax:
Practice Address - Street 1:611 E DOUGLAS RD STE 207
Practice Address - Street 2:
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-1465
Practice Address - Country:US
Practice Address - Phone:574-335-6850
Practice Address - Fax:574-335-0849
Is Sole Proprietor?:No
Enumeration Date:2011-06-30
Last Update Date:2024-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43015030082086X0206X
IN01094815A2086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical Oncology