MEDICARE: DR. MOHAMED-JAWAD SHAKARCHI DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	21304	MA

General Provider Information

NPI Number	:	1528193349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMED-JAWAD SHAKARCHI DDS

Provider Business Mailing Address
First Line	:	55 HARBOR VIEW PARK
Second Line	:
City	:	MILTON
State	:	MA
Zip	:	02186-5822
Country	:	US
Telephone Number	:	617-696-2381
Fax Number	:

Provider Business Practice Location Address
First Line	:	6C GROVE ST
Second Line	:
City	:	NORWELL
State	:	MA
Zip	:	02061-1534
Country	:	US
Telephone Number	:	508-223-3900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2007
Last Update Date	:	09/19/2007

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