Provider Demographics
NPI:1841356482
Name:WOMENS MEDICAL SPECIALISTS
Entity type:Organization
Organization Name:WOMENS MEDICAL SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KISHORI
Authorized Official - Middle Name:P
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:260-356-3611
Mailing Address - Street 1:1060 ETNA AVENUE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:46750
Mailing Address - Country:US
Mailing Address - Phone:260-356-3611
Mailing Address - Fax:260-358-4263
Practice Address - Street 1:1060 ETNA AVENUE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:IN
Practice Address - Zip Code:46750
Practice Address - Country:US
Practice Address - Phone:260-356-3611
Practice Address - Fax:260-358-4263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01026610A207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty