Provider Demographics
NPI:1588871586
Name:RANGEL, SHAWN J (MD)
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:J
Last Name:RANGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:300 LONGWOOD AVE
Mailing Address - Street 2:FEGAN 3
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5724
Mailing Address - Country:US
Mailing Address - Phone:617-355-3040
Mailing Address - Fax:617-730-0752
Practice Address - Street 1:300 LONGWOOD AVE
Practice Address - Street 2:FEGAN 3
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5724
Practice Address - Country:US
Practice Address - Phone:617-355-3040
Practice Address - Fax:617-730-0752
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2013-04-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35-0880272086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery