Provider Demographics
NPI:1699054924
Name:SHIMANOVSKY, ALEXEI (MD,)
Entity type:Individual
Prefix:DR
First Name:ALEXEI
Middle Name:
Last Name:SHIMANOVSKY
Suffix:
Gender:M
Credentials:MD,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3042
Mailing Address - Country:US
Mailing Address - Phone:508-448-3700
Mailing Address - Fax:508-488-2016
Practice Address - Street 1:20 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-3042
Practice Address - Country:US
Practice Address - Phone:508-448-3700
Practice Address - Fax:508-488-2016
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-04
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD16121207RH0003X
MA1015150207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology