Provider Demographics
NPI:1316119316
Name:SHASHI K AHUJA M.D.
Entity type:Organization
Organization Name:SHASHI K AHUJA M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHASHI
Authorized Official - Middle Name:KANT
Authorized Official - Last Name:AHUJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:260-425-3133
Mailing Address - Street 1:800 BROADWAY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46802-2149
Mailing Address - Country:US
Mailing Address - Phone:260-425-3133
Mailing Address - Fax:260-425-3110
Practice Address - Street 1:800 BROADWAY
Practice Address - Street 2:SUITE 300
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46802-2149
Practice Address - Country:US
Practice Address - Phone:260-425-3133
Practice Address - Fax:260-425-3110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2008-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01027373A207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty