Provider Demographics
NPI:1982086765
Name:AL SHAMI, FERAS (MD)
Entity Type:Individual
Prefix:
First Name:FERAS
Middle Name:
Last Name:AL SHAMI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:593 EDDY ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4923
Mailing Address - Country:US
Mailing Address - Phone:401-444-5033
Mailing Address - Fax:401-444-9822
Practice Address - Street 1:1 HERALD SQ
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-5009
Practice Address - Country:US
Practice Address - Phone:860-827-1343
Practice Address - Fax:860-827-1812
Is Sole Proprietor?:No
Enumeration Date:2015-06-29
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT57002207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology