| Dr Namrata Jagdish Shah, MD | |
|
1950 45th St Ste 200, Munster, IN 46321-3958 | |
| (219) 912-3376 | |
| (219) 529-6267 |
| Full Name | Dr Namrata Jagdish Shah |
|---|---|
| Gender | Female |
| Speciality | Dermatology |
| Location | 1950 45th St Ste 200, Munster, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548460173 | NPI | - | NPPES |
| 200880790A | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207N00000X | Dermatology | 01064342A (Indiana) | Primary |
| 207N00000X | Dermatology | 036-115856 (Illinois) | Secondary |
| Entity Name | Skin Dermatology, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386399749 PECOS PAC ID: 5991187577 Enrollment ID: O20220728001977 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Namrata Jagdish Shah, MD 1950 45th St Ste 200, Munster, IN 46321-3958 Ph: (219) 912-3376 | Dr Namrata Jagdish Shah, MD 1950 45th St Ste 200, Munster, IN 46321-3958 Ph: (219) 912-3376 |
Dr. Adam P Whittington, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 800 Macarthur Blvd Ste 6, Munster, IN 46321 Phone: 219-703-2417 Fax: 219-703-6947 | |
Dr. Vivek Singam, MD Dermatology Medicare: Medicare Enrolled Practice Location: 9200 Calumet Ave # 203, Munster, IN 46321 Phone: 219-228-4200 | |
Dr. Lauren Elisabeth Cerullo, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 9200 Calumet Ave, Ste 203, Munster, IN 46321 Phone: 219-228-4200 Fax: 844-965-9457 | |
Ahmad Fathi, MD Dermatology Medicare: Not Enrolled in Medicare Practice Location: 9130 Columbia Ave, Suite A, Munster, IN 46321 Phone: 219-836-4343 Fax: 219-836-4387 | |
Dr. Mark Gordon, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 7905 Calumet Ave, Munster, IN 46321 Phone: 219-836-7214 Fax: 219-836-7299 | |
Carolyn Huyen Trieu, PA-C Dermatology Medicare: Medicare Enrolled Practice Location: 1950 45th St Ste 200, Munster, IN 46321 Phone: 219-912-3376 Fax: 219-529-6267 |