Provider Demographics
NPI:1356198840
Name:SHI, DARREN (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:DARREN
Middle Name:
Last Name:SHI
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CANTERBURY LN
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1275
Mailing Address - Country:US
Mailing Address - Phone:207-838-8715
Mailing Address - Fax:
Practice Address - Street 1:45 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:SOUTH PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04106-2411
Practice Address - Country:US
Practice Address - Phone:207-772-2625
Practice Address - Fax:207-879-4246
Is Sole Proprietor?:No
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist