Individual
DR. MOHAMMAD SHAHABUDDIN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2100 DORCHESTER AVE, DORCHESTER CENTER, MA 02124-5615
(617) 296-4000
(617) 474-3820
Mailing address
165 PURITAN DR, QUINCY, MA 02169-1737
(617) 472-4519
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35707
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2050196
—
MA
Enumeration date
11/07/2005
Last updated
07/08/2007
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