Individual
EDWARD SHALOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2600 SIXTH ST SW, CANTON, OH 44710-1702
(330) 363-6223
(330) 363-3877
Mailing address
1290 SILAS DEANE HWY, HHC CVO ENROLLMENT 1ST FLOOR, WETHERSFIELD, CT 06109-4337
(860) 972-9093
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
68068
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2018
Last updated
07/07/2021
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