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General NPI Number Information
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NPI Number | 1396057386
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Entity Type | Organization
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Legal Business Name | HARRIS ALLEN SHAMPAIN MD PA
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Dates
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Enumeration Date | 07/08/2010
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Last Update Date | 07/10/2010
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Provider Practice Location Address
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Address Line | 2253 N UNIVERSITY DR
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3611
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Country | US
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Telephone | 954-963-3003
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Fax |
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Provider Business Mailing Address
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Address Line | 2253 N UNIVERSITY DR
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City | PEMBROKE PINES
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State | FL
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Zip | 33024-3611
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HARRIS A. SHAMPAIN
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Credential | M.D.
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Telephone | 954-963-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | ME42245
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License Number State | FL
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