Provider Demographics
NPI:1730937467
Name:SHAMIM, HUMRA
Entity type:Individual
Prefix:DR
First Name:HUMRA
Middle Name:
Last Name:SHAMIM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 CAMBRIDGE ST, SMC-8
Mailing Address - Street 2:BRIGHTON
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135
Mailing Address - Country:US
Mailing Address - Phone:518-961-6239
Mailing Address - Fax:
Practice Address - Street 1:736 CAMBRIDGE ST, SMC-8
Practice Address - Street 2:BRIGHTON
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02135
Practice Address - Country:US
Practice Address - Phone:518-961-6239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program