Healthcare Provider Details
I. General information
NPI: 1518983071
Provider Name (Legal Business Name): SHAZIA LATIF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/15/2006
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
303 N MAIN ST
ATTLEBORO MA
02703-1752
US
IV. Provider business mailing address
303 N MAIN ST
ATTLEBORO MA
02703-1752
US
V. Phone/Fax
- Phone: 508-222-2086
- Fax: 508-226-8552
- Phone: 508-222-2086
- Fax: 508-226-8552
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 227247 |
| License Number State | MA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: