Individual
SHORTA YUASA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
295 VARNUM AVE, LOWELL, MA 01854-2134
(978) 937-6161
Mailing address
295 VARNUM AVE, LOWELL, MA 01853-1802
(978) 937-6161
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
153944
MA
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
153944
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3171353
—
MA
01
—
J17924
BCBS
MA
Enumeration date
05/25/2006
Last updated
12/15/2015
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