Individual
CHARLES B SHANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1030 PRESIDENT AVE, SUITE 110, FALL RIVER, MA 02720-5923
(508) 235-6349
(508) 973-1715
Mailing address
200 MILL RD, STE 180, FAIRHAVEN, MA 02719-5252
(508) 973-2000
(508) 973-2001
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
54052
MA
207RG0100X
Gastroenterology Physician
MD06300
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000021258
BMC HEALTHNET
MA
01
—
0000025599
BC BS OF RI
RI
01
—
201678
BLUECHIP
RI
05
—
3048756
—
MA
01
—
6654
HARVARD PILGRIM
MA
01
—
J08749
BC BS OF MA
MA
Enumeration date
04/24/2006
Last updated
04/27/2020
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