Provider Demographics
NPI:1770748170
Name:SHAMS, MOHAMMED A (MD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMED
Middle Name:A
Last Name:SHAMS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:AMEERUDIN
Other - Middle Name:
Other - Last Name:SHAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:DEPARTMENT OF MEDICINE
Mailing Address - Street 2:435 LEWIS AVENUE
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06451-1185
Mailing Address - Country:US
Mailing Address - Phone:203-537-2558
Mailing Address - Fax:
Practice Address - Street 1:435 LEWIS AVE
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06451-2101
Practice Address - Country:US
Practice Address - Phone:203-537-2558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-24
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT049482207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine