Individual
SHABBIR REZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
711 COTTAGE GROVE RD, BLOOMFIELD, CT 06002-3060
(860) 242-8756
(860) 242-3052
Mailing address
1 MEDICAL CENTER DR, BIDDEFORD, ME 04005-9422
(207) 282-9080
(207) 282-4281
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
017782
ME
207RC0000X
Cardiovascular Disease Physician
Primary
71530
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432965699
—
ME
Enumeration date
04/02/2008
Last updated
08/15/2022
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