Divakaruni, Shashidhar

Divakaruni, Shashidhar is an individual health care provider with primary practice located at 1730 45Th Ave , Munster IN 46321-3915. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Cardiology, which is considered as his primary health care specialty. Divakaruni, Shashidhar can be contacted via phone (219) 836-9677.

Contact Information

Primary practice address
1730 45Th Ave Munster IN 46321-3915
Phone: (219) 836-9677
Fax: (219) 836-0688
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 01040667 Indiana

Profile Details

NPI number 1902936578
LBN Legal business name Divakaruni, Shashidhar
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 6th, 2007
Last updated Sep 15th, 2010 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902936578 NPPES
Indiana MEDICAID 100200170B
Indiana Other 90000999
Indiana Other 000000173830

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