Individual
SHANT BROUKIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
27 PARK ST, HYANNIS, MA 02601-5230
(508) 862-5981
Mailing address
27 PARK ST, HYANNIS, MA 02601-5230
(508) 862-5981
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
266018
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
266018
MEDICAL LICENSE
MA
Enumeration date
05/13/2013
Last updated
04/01/2023
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