IndividualActive
Michael Shao, MD
NPI 1508196122 · Vascular Surgery Physician · Fort Wayne, IN
Provider details
- NPI number
- 1508196122
- Entity type
- Individual
- Primary specialty
- Vascular Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- 036117153 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
1818 Carew St Ste 230
Fort Wayne, IN 46805-4764
Phone: (260) 266-4640
Fax: (260) 266-4638
Approximate (ZIP-level) locationGet directions
Mailing address
11109 Parkview Plaza Dr # 117
Fort Wayne, IN 46845-1701
Registry dates
- Enumerated
- 2010-01-04
- Last updated
- 2025-03-03
- Certified
- 2025-03-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.