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Individual

SHIDEH DEURELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5 INDUSTRIAL DR, WINDHAM, NH 03087-2021
(603) 685-0150
Mailing address
5 INDUSTRIAL DR, WINDHAM, NH 03087-2021
(603) 685-0150

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
16192
NH
208000000X
Pediatrics Physician
A7110
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100509295
NV
Enumeration date
09/13/2006
Last updated
06/30/2016
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