Individual
DR. UDAY SHANKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3801 E MAIN ST FL 2, WATERBURY, CT 06705
(203) 709-4001
Mailing address
3801 E MAIN ST FL 2, WATERBURY, CT 06705-3815
(203) 709-4001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
003922
NY
207RG0100X
Gastroenterology Physician
Primary
62492
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
62492
MEDICAL LICENSE
CT
01
—
ME114150
FLORIDA LICENSE
FL
Enumeration date
10/21/2011
Last updated
10/28/2021
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