Individual
DR. RANDHEER SHAILAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, ELL 2 RADIOLOGICAL ASSOCIATES, BOSTON, MA 02114-2696
(617) 724-4207
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 724-4207
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
225354
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2106701
—
MA
01
—
478715
TUFTS HEALTH PLAN
MA
01
—
J29065
BCBS MA
MD
Enumeration date
11/02/2005
Last updated
08/09/2012
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