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Individual

DR. SHAIDAH DEGHAN MANSHADI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
55 FRUIT ST, BOSTON, MA 02114-2621
(416) 834-7334
Mailing address
55 FRUIT ST, BOSTON, MA 02114-2621

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
1020791
MA
2086S0129X
Vascular Surgery Physician
Primary
112664
ZZ
2086S0129X
Vascular Surgery Physician
Primary
112664
2086S0129X
Vascular Surgery Physician
38729
NH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
112664
CANADIAN PHYSICIANS AND SURGEONS OF ONTARIO
05
3147410
NH
Enumeration date
07/03/2023
Last updated
01/27/2026
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