Individual
PRAMODCHANDRA C SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
365 MAIN ST, WINTHROP, MA 02152
(617) 846-5352
(617) 846-1062
Mailing address
29 BLUE JAY RD, LYNNFIELD, MA 01940
(781) 581-5038
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34904
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2008912
—
MA
Enumeration date
03/14/2006
Last updated
10/21/2011
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