Individual
SHAWN M FERULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
25 CARLETON ST, CAMBRIDGE, MA 02142-1323
(617) 253-2974
(617) 253-5512
Mailing address
77 MASSACHUSETTS AVE, MASSACHUSETTS INSTITUTE OF TECHNOLOGY, E23-171, CAMBRIDGE, MA 02139-4301
(617) 253-2974
(617) 253-5512
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
219827
MA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
219827
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2037106
—
MA
Enumeration date
02/15/2006
Last updated
11/20/2023
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