Fadia, Shruti A

Fadia, Shruti A is an individual health care provider with primary practice located at 100 Navarre Pl Suite 5550, South Bend IN 46601-1156. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Endocrinology. Allopathic & Osteopathic Physicians / Pediatric Endocrinology is her primary health care specialty. Fadia, Shruti A can be contacted via phone (574) 647-2550.

Contact Information

Primary practice address
100 Navarre Pl Suite 5550 South Bend IN 46601-1156
Phone: (574) 647-2550
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MT192950 Pennsylvania
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 01074405A Indiana
Allopathic & Osteopathic Physicians / Pediatric Endocrinology 2080P0205X 01074405A Indiana

Profile Details

NPI number 1669634770
LBN Legal business name Fadia, Shruti A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2008
Last updated Mar 15th, 2021 - about 5 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 1669634770 NPPES
Indiana MEDICAID 201247820

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