Provider Demographics
NPI:1386630226
Name:SHAMA, STEVEN K (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:K
Last Name:SHAMA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1 BROOKLINE PL
Mailing Address - Street 2:SUITE 406
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7224
Mailing Address - Country:US
Mailing Address - Phone:617-277-8332
Mailing Address - Fax:617-277-8105
Practice Address - Street 1:1 BROOKLINE PL
Practice Address - Street 2:SUITE 406
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7224
Practice Address - Country:US
Practice Address - Phone:617-277-8332
Practice Address - Fax:617-277-8105
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA36103207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3017435Medicaid
MAE05186Medicare ID - Type Unspecified
B97524Medicare UPIN