Provider Demographics
NPI:1396767455
Name:NADKARNI, SHAMAL D (MD)
Entity type:Individual
Prefix:
First Name:SHAMAL
Middle Name:D
Last Name:NADKARNI
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 1:1050 NW 8TH AVE
Mailing Address - Street 2:SUITE 30
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32601-4998
Mailing Address - Country:US
Mailing Address - Phone:352-271-3200
Mailing Address - Fax:352-271-3900
Practice Address - Street 1:1050 NW 8TH AVE
Practice Address - Street 2:SUITE 30
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32601-4998
Practice Address - Country:US
Practice Address - Phone:352-271-3200
Practice Address - Fax:352-271-3900
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME65395207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
208304OtherAVMED
FL377916500Medicaid
FLDR830AOtherMEDICARE PTAN
27074OtherBCBS
G05208Medicare UPIN
FL377916500Medicaid