Individual
DR. PREM SHANKER SHUKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
489 STATE ST, BANGOR, ME 04401-6616
(732) 923-6540
Mailing address
43 WHITING HILL RD STE 300, BREWER, ME 04412-1006
(207) 973-6676
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD2206
ME
Other
Enumeration date
06/29/2015
Last updated
11/30/2018
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