Basic Information
| Provider Information | |||||||||
| NPI: | 1417332479 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | SHANKER | ||||||||
| FirstName: | SWAROOP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 285 PLANTATION ST | ||||||||
| Address2: | APARTMENT 322 | ||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016047701 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 123 SUMMER ST | ||||||||
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| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 016081216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5083636208 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2015 | ||||||||
| LastUpdateDate: | 01/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 263792 | MA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | D84678 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | D84678 | MD | Y | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.