KHURRUM A SHAIKH (NPI# 1386683068) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386683068 |
| Entity Type | Individual |
| Full Name | KHURRUM A SHAIKH |
| Credential | MD |
| Practice Address |
2520 E Dupont Rd Fort Wayne IN 46825-1675 |
| Mailing Address |
6435 W Jefferson Blvd Pmb 109 Fort Wayne IN 46804-6203 |
| Practice Telephone | 2603444035 |
| Practice Fax Number | 2609699272 |
| Mailing Telephone | 2603444035 |
| Mailing Fax Number | 2609699272 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2016-06-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 35079807 | OH | Allopathic & Osteopathic Physicians |
| Y | 207R00000X | Internal Medicine | 01061057 | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200826790 | 05 | |
| IN | ANTHEM | 000000547249 | 01 |
| IN | CIGNA | 079774180 | 01 |
| IN | PHP | 20549 | 01 |
| OH | 0064359 | 05 |
| Street Address |
2520 E DUPONT RD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46825-1675 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538110556 | Dupont Hospital LLC | General Acute Care Hospital | 2520 E Dupont Rd, Fort Wayne, IN 46825-1675 | 2006-05-15 |
| 1558905364 | Kari Louise Hackley | Nurse Practitioner | 2520 E Dupont Rd, Fort Wayne, IN 46825-1675 | 2019-11-05 |
| 1184138349 | Candace Jo Nicholas | Nurse Practitioner | 2520 E Dupont Rd, Fort Wayne, IN 46825-1675 | 2017-11-27 |
| 1346752870 | Stacy Rose Masters | Registered Nurse | 2520 E Dupont Rd, Fort Wayne, IN 46825-1675 | 2017-10-24 |
| 1942724547 | Doug Wesley Brady | Nurse Practitioner | 2520 E Dupont Rd, Fort Wayne, IN 46825-1675 | 2017-07-26 |
| 1699129148 | Kimberly Mcmurray | Nurse Practitioner | 2520 E Dupont Rd, Fort Wayne, IN 46825-1675 | 2016-04-21 |
| 1508227042 | Rachel Stephens | Dietitian, Registered | 2520 E Dupont Rd, Fort Wayne, IN 46825-1675 | 2016-03-11 |
| 1922468651 | Jodi Selking | Dietitian, Registered | 2520 E Dupont Rd, Fort Wayne, IN 46825-1675 | 2016-02-23 |
| 1770942427 | Rachel Griffin | Registered Nurse | 2520 E Dupont Rd, Fort Wayne, IN 46825-1675 | 2016-02-22 |
| 1659738185 | Constance Harding | Dietitian, Registered | 2520 E Dupont Rd, Fort Wayne, IN 46825-1675 | 2016-01-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336772078 | Bradley Murphy | Occupational Therapist | 2626 St Joe Center Ed, Fort Wayne, IN 46825 | 2020-02-21 |
| 1144851015 | Sabryna Roman | Developmental Therapist | 2626 St Joe Center Rd, Fort Wayne, IN 46825 | 2020-01-30 |
| 1205474103 | Ashleigh Miller | Developmental Therapist | 2626 St. Joe Center Rd, Fort Wayne, IN 46825 | 2019-12-11 |
| 1962055152 | Carehalo Ohio LLC | General Practice | 2510 Dupont Circle Dr., Suite 201, Fort Wayne, IN 46825 | 2019-07-17 |
| 1306318175 | Logan Alan Williams | Nurse Anesthetist, Certified Registered | 10315 Dawsons Creek Blvd Ste B, Fort Wayne, IN 46825 | 2018-12-18 |
| 1326582925 | Mark F Stoner LLC | Dentist | 9830 Auburn Rd Suite 102, Fort Wayne, IN 46825 | 2016-12-15 |
| 1336695782 | Nadine Rene' Handy | Nurse Practitioner | 3978 New Vision Dr., Fort Wayne, IN 46825 | 2016-08-26 |
| 1558815712 | Nathan Paul Miller | Physical Therapist | 10006 Auburn Park Dr, Fort Wayne, IN 46825 | 2016-08-05 |
| 1013366905 | Brianna Abbott | Physician Assistant | 1234 E Dupont Rd Ste 7, Fort Wayne, IN 46825 | 2016-06-10 |
| 1003276643 | Seiss, LLC | Psychologist | 9910 Dupont Circle Drive, Suite 140, Fort Wayne, IN 46825 | 2016-02-24 |
| Find all providers in zip 46825 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053709402 | Sheila Falloon Md LLC | Internal Medicine | 6232 Shady Creek Ct, Fort Wayne, IN 46814-3298 | 2015-01-07 |
| 1043644354 | Fort Wayne Medical Clinic PC | Internal Medicine | 3537 N Anthony Blvd Ste C, Fort Wayne, IN 46805-1423 | 2013-08-23 |
| 1275975682 | Lakshmi Mohan Viji Das | Internal Medicine | 11143 Parkview Plaza Dr Ste 311, Fort Wayne, IN 46845 | 2013-07-26 |
| 1215377296 | Ram Kishun Verma | Internal Medicine | 1234 E Dupont Rd Ste 5, Fort Wayne, IN 46825 | 2013-07-05 |
| 1871840934 | Amabel Pia A Lapuebla | Internal Medicine | 11104 Parkview Circle Dr Ste 440, Fort Wayne, IN 46845-1672 | 2012-08-08 |
| 1538432141 | C & D Healthcare Services, LLC | Internal Medicine | 327 E Wayne St, Fort Wayne, IN 46802-2753 | 2012-02-13 |
| 1407141500 | Patrick Joseph Wise | Internal Medicine | 6435 W Jefferson Blvd, Fort Wayne, IN 46804-6203 | 2011-06-16 |
| 1235438185 | Blue Crescent Blue Star Medical of Indiana, Inc | Internal Medicine | 2326 Hobson Rd, Fort Wayne, IN 46805-2916 | 2011-03-17 |
| 1336441948 | Vishaal Veerula | Internal Medicine | 7802 W. Jefferson Blvd. #b, Fort Wayne, IN 46804 | 2010-12-02 |
| 1609019900 | Srisai P C | Internal Medicine | 7972 West Jefferson Blvd, Suite A, Fort Wayne, IN 46804-4140 | 2009-04-16 |
| Find all providers in FORT WAYNE | ||||
| City | FORT WAYNE |
| Zip Code | 46825 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.