Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Prem Shanker Shukla, MD

Individual provider Internal Medicine Physician · NPI 1053794891

Dr. Prem Shanker Shukla, MD is an Internal Medicine in Bangor, Maine. Qualified in 2012, 14 years ago. Practices with Coastal Medical Associates, a 446-clinician group and accepts Medicare assignment. Licensed in Maine.

Years since qualifying
14
Licensed in
ME
In the registry since
2015
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

489 State St
Bangor, ME 04401-6616
Phone: (732) 923-6540
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence MD2206 (ME)

Record details

NPI number1053794891
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 29, 2015
Last updated in NPPESNovember 30, 2018

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyINTERNAL MEDICINE
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Coastal Medical Associates — 446 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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