Provider Demographics
NPI:1942248984
Name:DRS. SHASHY AND SHASHY PA
Entity type:Organization
Organization Name:DRS. SHASHY AND SHASHY PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHASHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-262-4418
Mailing Address - Street 1:1722 PINE ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36106-1103
Mailing Address - Country:US
Mailing Address - Phone:334-262-4418
Mailing Address - Fax:334-264-5483
Practice Address - Street 1:1722 PINE ST
Practice Address - Street 2:SUITE 204
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36106-1103
Practice Address - Country:US
Practice Address - Phone:334-262-4418
Practice Address - Fax:334-264-5483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL13201208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC76506Medicare UPIN