Provider Demographics
NPI:1124688221
Name:SHAH, AADITYA VIJAY (MD)
Entity type:Individual
Prefix:DR
First Name:AADITYA
Middle Name:VIJAY
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8895 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-7037
Mailing Address - Country:US
Mailing Address - Phone:219-259-1760
Mailing Address - Fax:219-259-1767
Practice Address - Street 1:8895 BROADWAY
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-7037
Practice Address - Country:US
Practice Address - Phone:219-259-1760
Practice Address - Fax:219-259-1767
Is Sole Proprietor?:No
Enumeration Date:2019-06-19
Last Update Date:2025-07-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2023016112207WX0107X
IN01095570A207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200073153Medicaid