Individual
MIR SHUTTARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
90 TER HEUN DR, FALMOUTH, MA 02540-2533
(508) 548-8574
Mailing address
PO BOX 905, FALMOUTH, MA 02541
(508) 548-8989
(508) 548-5789
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
52726
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0105961
—
MA
01
—
052726
TUFTS HEALTH
MA
01
—
23598
HARVARD PILGRIM
MA
Enumeration date
05/18/2006
Last updated
02/02/2009
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