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
| License | State | Type | Specialty |
|---|---|---|---|
| 054955 | CT | MD | Internal Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 054955 | Medicaid | CT |
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All providers in Apple Valley, MN · Internal Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.