Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 01068324A | IN |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 57.007689 | OH |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | D68443 | MD |
NPI | 1023288230 |
---|---|
Provider Name | Dr. Taha Z Shipchandler |
First Address | Indianapolis, IN 46219-4959 |
Second Address | Carmel, IN 46032-3009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2008 |
Last Update Date | 16/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200987260 | (05) | IN |
417355400 | (05) | MD |