Provider Demographics
NPI:1457308249
Name:MONTAGUE, SHAHNAZ (MD)
Entity Type:Individual
Prefix:
First Name:SHAHNAZ
Middle Name:
Last Name:MONTAGUE
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 1:3 FRANKLIN COMMONS
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6619
Mailing Address - Country:US
Mailing Address - Phone:508-872-9151
Mailing Address - Fax:
Practice Address - Street 1:3 FRANKLIN COMMONS
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6619
Practice Address - Country:US
Practice Address - Phone:508-872-9151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA55438207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine