Pandian, Shobana
Pandian, Shobana is an individual health care provider with primary practice located at 10515 Illinois Rd , Fort Wayne IN 46814. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Pandian, Shobana can be contacted via phone (260) 373-9200.Contact Information
Primary practice address
10515 Illinois Rd
Fort Wayne IN 46814
Phone: (260) 373-9200
Fax: (260) 373-9219
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 01058626A | Indiana |
Profile Details
| NPI number | 1619940970 |
|---|---|
| LBN Legal business name | Pandian, Shobana |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 8th, 2006 |
| Last updated | Nov 27th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619940970 | NPPES |
| Indiana | Other | 146470C5 | MEDICARE |
| Indiana | MEDICAID | 200856050 | MEDICARE |
| Indiana | Other | 000000658068 | MEDICARE |
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