Individual ProviderAbhijit ShuklaInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701(260) 672-6620PECOS EnrollmentBased on the most recent information from CMS, provider Abhijit Shukla is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1760464465Provider TypeIndividualFull NameShukla, AbhijitCredentialM.D.GenderMaleSole ProprietorYesEnumeration Date11/17/2005Last Updated4/10/2023Contact InformationPractice LocationPractice Address11109 Parkview Plaza Dr, Fort Wayne, IN 46845-1701Phone(260) 672-6620Fax(260) 672-6639Mailing LocationMailing Address11109 Parkview Plaza Dr # 117, Fort Wayne, IN 46845-1701PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense01061227AIndianaCode208M00000XDescriptionHospitalistAllopathic & Osteopathic PhysiciansLicense01061227AIndianaProvider IdentifiersIDDescriptionIssuerIDP00465489DescriptionOtherIssuerRAILROAD MEDICAREIndianaID200802100DescriptionMedicaidIssuerUnlistedIndianaID000000527029DescriptionOtherIssuerANTHEMIndiana