Provider Demographics
NPI:1730147646
Name:SHMASE, FREDERIC S (MD)
Entity type:Individual
Prefix:
First Name:FREDERIC
Middle Name:S
Last Name:SHMASE
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 1:2 ESSEX CENTER DR
Mailing Address - Street 2:
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-2926
Mailing Address - Country:US
Mailing Address - Phone:978-532-2800
Mailing Address - Fax:
Practice Address - Street 1:2 ESSEX CENTER DR
Practice Address - Street 2:
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-2926
Practice Address - Country:US
Practice Address - Phone:978-532-2800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA30635207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0016151OtherNEIGHBORHOOD HEALTH
MAD15013OtherBLUE CROSS
MA5753965-005OtherCIGNA
MA64455OtherHARVARD PILGRIM
MA030635OtherTUFTS
MA3123430Medicaid
MA3214520OtherAETNA
MA0016151OtherNEIGHBORHOOD HEALTH
MA030635OtherTUFTS