Basic Information
Provider Information
NPI: 1225245640
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARSHAD
FirstName: SHIROO
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6626 E 75TH ST STE 500
Address2:  
City: INDIANAPOLIS
State: IN
PostalCode: 462502890
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 7979 N SHADELAND AVE
Address2: STE 200
City: INDIANAPOLIS
State: IN
PostalCode: 462502042
CountryCode: US
TelephoneNumber: 3176214300
FaxNumber: 3176214301
Other Information
ProviderEnumerationDate: 05/16/2007
LastUpdateDate: 09/28/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/28/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X01071516AINY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

ID Information
IDTypeStateIssuerDescription
087025601INCIGNAOTHER
20108328005IN MEDICAID
P0129358401INMEDICARE RROTHER
991195301INAETNAOTHER
00000086121101INANTHEMOTHER
P0175121301INRR MEDICAREOTHER


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