Individual
MR. NOAM ELAN SHABANI
Active
Individual
MR. NOAM ELAN SHABANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
763078
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA5530
COMMONWEALTH OF MASSACHUSETTS, DEPARTMENT OF PUBLIC HEALTH
MA
Enumeration date
10/08/2015
Last updated
10/08/2015
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