Individual
HAROHALLI R SHASHIDHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
275 MAMMOTH RD, SUITE 1, MANCHESTER, NH 03109-4133
(603) 663-3222
Mailing address
275 MAMMOTH RD, MANCHESTER, NH 03109-4133
(603) 663-3222
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
15360
NH
2080P0206X
Pediatric Gastroenterology Physician
34403
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32000745
—
NH
05
—
64018575
—
KY
Enumeration date
07/12/2006
Last updated
03/27/2012
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