Individual
SHIVA SABOORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
150 PARK ST, LAWRENCE, MA 01841-2517
(978) 685-1770
(978) 685-4390
Mailing address
150 PARK ST, LAWRENCE, MA 01841-2517
(978) 685-1770
(978) 685-4390
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
73671
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1303775
—
MA
Enumeration date
08/31/2005
Last updated
10/21/2010
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