Provider Demographics
NPI:1942287677
Name:SHAMOON-MICHAUD, SABA ADEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SABA
Middle Name:ADEL
Last Name:SHAMOON-MICHAUD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 LEBARON WAY
Mailing Address - Street 2:
Mailing Address - City:MATTAPOISETT
Mailing Address - State:MA
Mailing Address - Zip Code:02739-1210
Mailing Address - Country:US
Mailing Address - Phone:508-758-4412
Mailing Address - Fax:508-996-3443
Practice Address - Street 1:404 HUTTLESTON AVE
Practice Address - Street 2:
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-5630
Practice Address - Country:US
Practice Address - Phone:508-996-9333
Practice Address - Fax:508-996-3443
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA159509208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics