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Individual

LEONARD H SHAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
100 WASON AVENUE, SUITE 120, SPRINGFIELD, MA 01107-1119
(413) 241-2100
(413) 735-1986
Mailing address
100 WASON AVENUE, SUITE 120, SPRINGFIELD, MA 01107-1119
(413) 241-2100
(413) 735-1986

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
70483
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3049035
MA
01
J08438
BLUE CROSS BLUE SHIELD
MA
Enumeration date
05/01/2006
Last updated
06/17/2010
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