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Individual

BAHRAM SHAH-HOSSEINI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2 DUDLEY ST, SUITE 510, PROVIDENCE, RI 02905-3236
(401) 453-3433
(401) 453-0695
Mailing address
30 BRIARWOOD RD, LINCOLN, RI 02865-1003
(401) 453-3433
(401) 333-3359

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD04758
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
MD04758
STATE LICENSE
RI
Enumeration date
06/30/2006
Last updated
03/07/2023
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