1598946451 NPI number — PETER SHENG MD INC

Table of content: (NPI 1598946451)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598946451 NPI number — PETER SHENG MD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PETER SHENG MD INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598946451
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/14/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8280 MONTGOMERY RD.
Provider Second Line Business Mailing Address:
STE. 100
Provider Business Mailing Address City Name:
CINCINNATI
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45236
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-528-5900
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8280 MONTGOMERY RD
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
CINCINNATI
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-528-5900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/20/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SHEN
Authorized Official First Name:
CHE-MING
Authorized Official Middle Name:
JASMIN
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
513-528-2900

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  35047646 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X , with the licence number: 35047646 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0599106 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".