Provider Demographics
NPI:1902844327
Name:SHALNOV, ANATOLY P (MD)
Entity Type:Individual
Prefix:DR
First Name:ANATOLY
Middle Name:P
Last Name:SHALNOV
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1493 CAMBRIDGE ST
Mailing Address - Street 2:CAMBRIDGE HOSPITAL
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-1047
Mailing Address - Country:US
Mailing Address - Phone:617-665-2960
Mailing Address - Fax:617-623-0243
Practice Address - Street 1:1493 CAMBRIDGE ST
Practice Address - Street 2:CAMBRIDGE HOSPITAL
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-1047
Practice Address - Country:US
Practice Address - Phone:617-665-2960
Practice Address - Fax:617-623-0243
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA226426208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA39517Medicare UPIN
MA147509Medicare ID - Type Unspecified