| Sha LLC | |
|
2101 Broadway St Clarksville IN 47129-7800 | |
| (812) 913-6880 | |
| Not Available |
| Full Name | Sha LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 2101 Broadway St, Clarksville, Indiana |
| Authorized Official Name and Position | Hasan Abbas (OWNER) |
| Authorized Official Contact | 5024801567 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sha LLC Po Box 116 Prospect KY 40059-0116 Ph: (502) 480-1567 | Sha LLC 2101 Broadway St Clarksville IN 47129-7800 Ph: (812) 913-6880 |
| NPI Number | 1578431656 |
|---|---|
| Provider Enumeration Date | 10/29/2025 |
| Last Update Date | 11/19/2025 |
| Certification Date | 11/19/2025 |
| Medicare PECOS PAC ID | 5092200212 |
|---|---|
| Medicare Enrollment ID | O20251224001040 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578431656 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Syed Hassan Abbas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285081398 PECOS PAC ID: 4789921529 Enrollment ID: I20231226001004 |
| Provider Name | Mehrunissa Kazim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043763782 PECOS PAC ID: 8527347459 Enrollment ID: I20240409001512 |
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