| Dr Himanshu Shah, MD | |
|
801 Saint Marys Dr, Suite 502 East, Evansville, IN 47714-0511 | |
| (812) 485-1785 | |
| (812) 485-1890 |
| Full Name | Dr Himanshu Shah |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 801 Saint Marys Dr, Evansville, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821090085 | NPI | - | NPPES |
| 100122510C | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 01036039A (Indiana) | Primary |
| Entity Name | St Marys Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164852539 PECOS PAC ID: 1153493341 Enrollment ID: O20140313001275 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Himanshu Shah, MD 3700 Bellemeade Ave Ste 117, Evansville, IN 47714-0106 Ph: (812) 437-4333 | Dr Himanshu Shah, MD 801 Saint Marys Dr, Suite 502 East, Evansville, IN 47714-0511 Ph: (812) 485-1785 |
Dr. Mohammad I Hussain, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 801 St Marys Dr, Suite 203 E, Evansville, IN 47714 Phone: 812-479-8566 | |
Dr. Carol Lynn Berseth, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 401 Park Plaza Dr, Evansville, IN 47715 Phone: 812-471-8984 | |
William Selby, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 7220 E Virginia St, Evansville, IN 47715 Phone: 812-473-8986 | |
Jason R Wiles, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 3700 Washington Ave, Evansville, IN 47714 Phone: 812-485-4000 | |
Douglas S Palmenter, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1231 Washington Square, Evansville, IN 47715 Phone: 812-479-6907 Fax: 812-479-6967 | |
Dr. Lata R Shukla, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 7220 E Virginia St, Evansville, IN 47715 Phone: 812-473-8986 Fax: 812-471-6692 | |
Richard Cleavelin Probert, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 25 W Division St, Suite 400 West, Evansville, IN 47710 Phone: 812-436-4501 Fax: 812-436-4510 |