Shama Kumari Ahuja, M.D.

Individual provider Active NPI Internal Medicine Physician · Apple Valley, MN

NPI 1144360330 · NPPES record last updated Jul 18, 2017

Key facts

NPI
1144360330
Entity type
Individual (NPI type 1)
Primary specialty
Internal Medicine Physician 207R00000X
License
054955 (CT)
Practice address
14655 Galaxie Ave
Apple Valley, MN 55124-8602
Phone
(952) 432-6161
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
054955CTMDInternal Medicine Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 054955 CT Yes

Addresses

Primary practice location

14655 Galaxie Ave
Apple Valley, MN 55124-8602

Mailing address

14655 Galaxie Ave
Apple Valley, MN 55124-8602
Phone (952) 432-6161

Other identifiers

IdentifierTypeStateIssuer
054955MedicaidCT

Other providers in Apple Valley, MN

All providers in Apple Valley, MN · Internal Medicine Physician in Minnesota

Sources for this page

Verify at the official NPI Registry.