Individual
DR. ERUM SHAHAB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
16 MAIN ST, ELLINGTON, CT 06029-3360
(860) 871-5402
(860) 871-5413
Mailing address
16 MAIN ST, ELLINGTON, CT 06029-3360
(860) 871-5402
(860) 871-5413
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
0431121
CT
2084P0800X
Psychiatry Physician
043112
CT
2084P0800X
Psychiatry Physician
Primary
0431121
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669434049
—
CT
Enumeration date
04/03/2006
Last updated
12/21/2015
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