Shadi M Resheidat MD

NPI 1790895571 - Family Medicine - 207Q00000X

NPI Details
NPI 1790895571
Gender Male
Enumeration Date 08/30/2006
Last Updated 03/30/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
3554 PROMENADE PKWY
SUITE F
LAFAYETTE IN, 47909-8418, US
Phone (765) 471-9146
Fax (765) 477-0277
Business Location
PO BOX 4699
LAFAYETTE IN, 47903-4699, US
Phone (765) 449-2732
Fax (765) 449-1196
Toxanomy
Taxonomy Code 207Q00000X
License State Indiana
License Number 01058532A
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According to our database, Shadi M Resheidat MD NPI is 1790895571, taxonomy code is 207Q00000X and license number is 01058532A, license state is located at Indiana. Shadi M Resheidat MD physically located at 3554 Promenade Pkwy, Lafayette IN, 47909-8418. NPI Number Shadi M Resheidat MD has the Individual type.

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1790895571 NPI number is provided on an as is basis without warranty of any kind. 1790895571 is maintained by the National Plan & Provider Enumeration System. The contents of Shadi M Resheidat MD are for informational purposes only.