Individual
ANATOLI SHABASHOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 665-1240
Mailing address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 665-1240
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
208534
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA54253
HARVARD PILGRIM HEALTH PLAN
MA
Enumeration date
05/28/2006
Last updated
02/09/2012
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