| Doctor Name: | SHABNAM MOSHREF |
| NPI Number: | 1275844102 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O. |
| License Number: | 5101018943 |
| Business Practice Address: | 8920 Southpointe Dr Suite B Indianapolis, IN - 462277509 |
| Business Phone Number: | 3174971900 |
| Business Fax Number: | 3174971919 |
| Mailing Address: | 6626 E. 75th Street, Suite 500 INDIANAPOLIS |
| State: | IN |
| Postal Code: | 462502890 |
| Phone Number: | 3174976333 |
| Fax Number: | 3174971919 |
| NPI Enumeration Date: | 06/25/2010 |
| NPI Last Update Date: | 03/09/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 5101018943 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |