1821109588

Everything you always wanted to know about DR. SEQUEIRA R SHOBA M.D. but were afraid to ask.

DR. SEQUEIRA R SHOBA M.D.

You can also download the this 1821109588 data report as csv | excel | json | xml
Provider Prefix Provider Last Name Provider Middle Name Provider First Name Provider Credential
DR. SEQUEIRA R SHOBA M.D.
Gender:
Female
Enumeration date:
2006-08-31
Last update date:
2007-07-08
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state
6172016 Medicaid none MA

Taxonomies

Taxonomy State License Number Primary?
2085R0202X Diagnostic Radiology MA 40122 Y

Phone Numbers

Type Number
Mailing Address Telephone Number 6173327278
Practice Location Address Telephone Number 6174213100

Addresses

Type Address City State Postal Country
Mailing Address 80 WOODCHESTER DR CHESTNUT HILL MA 2467 MA
Practice Location Address 133 BROOKLINE AVE BOSTON MA 2215 MA

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