Provider Demographics
NPI:1205030483
Name:SHUKAIR, NAWRAS SALAMH (MD)
Entity Type:Individual
Prefix:
First Name:NAWRAS
Middle Name:SALAMH
Last Name:SHUKAIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:26 QUEEN ST
Practice Address - Street 2:PSYCHIATRIC TREATMENT AND RECOVERY CENTER
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01610-2473
Practice Address - Country:US
Practice Address - Phone:508-856-6580
Practice Address - Fax:508-334-2780
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1609292084P0800X
CT705462084P0800X
IDM-170272084P0800X
NJ25MA112998002084P0800X
MA2399172084P0800X
VT042.00156942084P0800X
AZ648252084P0800X
WAMD613682092084P0800X
NY3251212084P0800X
TXU20142084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110084102AMedicaid
MA001198301Medicare PIN