Provider Demographics
NPI:1235112319
Name:SHULMAN, GERALD I (MD)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:I
Last Name:SHULMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:YALE SCHOOL OF MEDICINE, DEPT OF INTERNAL MEDICINE
Mailing Address - Street 2:TAC, ROOM S269, PO BOX 208020
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06520-8020
Mailing Address - Country:US
Mailing Address - Phone:203-785-5447
Mailing Address - Fax:203-785-3823
Practice Address - Street 1:789 HOWARD AVE
Practice Address - Street 2:DANA BUILDING, 3RD FLOOR
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06519-1304
Practice Address - Country:US
Practice Address - Phone:203-737-1932
Practice Address - Fax:203-785-3588
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2018-03-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CT027683207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001276831Medicaid
CT110001879Medicare ID - Type Unspecified
CT001276831Medicaid