Provider Demographics
NPI:1295083624
Name:HOSPITAL CARE GROUP, P.C.
Entity type:Organization
Organization Name:HOSPITAL CARE GROUP, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KHURRUM
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:260-312-7139
Mailing Address - Street 1:6435 W JEFFERSON BLVD
Mailing Address - Street 2:PMB 109
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-6203
Mailing Address - Country:US
Mailing Address - Phone:260-312-7139
Mailing Address - Fax:
Practice Address - Street 1:6435 W JEFFERSON BLVD
Practice Address - Street 2:PMB 109
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804
Practice Address - Country:US
Practice Address - Phone:260-344-4035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPITAL CARE GROUP, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-15
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0071471Medicaid
OH0071471Medicaid