Individual
SHASHI K SRINIVASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2441 GREAR ST NE, SALEM, OR 97301-2749
(503) 588-0469
(402) 559-9840
Mailing address
2441 GREAR ST NE, SALEM, OR 97301-2749
(503) 588-0469
(402) 559-9840
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD26977
NE
207R00000X
Internal Medicine Physician
21603
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47078557521
—
NE
Enumeration date
05/11/2006
Last updated
09/11/2025
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