Provider Demographics
NPI:1538507512
Name:SHAH, AMEER TRILOK (MD)
Entity Type:Individual
Prefix:DR
First Name:AMEER
Middle Name:TRILOK
Last Name:SHAH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:68 OTIS ST UNIT 1
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-1719
Mailing Address - Country:US
Mailing Address - Phone:617-838-3586
Mailing Address - Fax:
Practice Address - Street 1:35 PEARL ST STE 200
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301
Practice Address - Country:US
Practice Address - Phone:508-588-8034
Practice Address - Fax:508-897-0475
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2018-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA273797207Y00000X
MA255848207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology