Provider Demographics
NPI:1790098010
Name:DEMEHRI, SHADMEHR (SHAWN) (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SHADMEHR (SHAWN)
Middle Name:
Last Name:DEMEHRI
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50, STANIFORD STREET
Mailing Address - Street 2:C B 8123
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:50 STANIFORD ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2517
Practice Address - Country:US
Practice Address - Phone:617-726-6097
Practice Address - Fax:617-726-7417
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA263079207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology