Doctor Name: | DR. ERUM SHAHAB |
NPI Number: | 1669434049 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | 0431121 |
Business Practice Address: | 16 Main St Ellington, CT - 060293360 |
Business Phone Number: | 8608715402 |
Business Fax Number: | 8608715413 |
Mailing Address: | 16 Main St, ELLINGTON |
State: | CT |
Postal Code: | 060293360 |
Phone Number: | 8608715402 |
Fax Number: | 8608715413 |
NPI Enumeration Date: | 04/03/2006 |
NPI Last Update Date: | 12/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 0431121 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CT |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |