NPI 1952758096

Unknown Shisram, MSCMHDSMDMH

Practitioner Psychiatry Physician Pago Pago, AS

Practice location

Address: 96799 Turner Drive, Pago Pago, AS 96799-9994
Phone: (684) 633-1222
Fax: (684) 633-2893
Mailing address: PO Box Lbj, Pago Pago, AS 96799-9994

Registered specialties

Psychiatry Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2084P0800X Licence 2182-C (AS)

Other Psychiatry & Neurology providers in American Samoa →

Registry record

NPI: 1952758096
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 May 2016
Record last updated: 18 May 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.