MEDICARE: JOHN H SHIM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	ME0063979	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285626762
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN H SHIM MD

Provider Business Mailing Address
First Line	:	PO BOX 2220
Second Line	:
City	:	OLDSMAR
State	:	FL
Zip	:	34677-7220
Country	:	US
Telephone Number	:	813-814-9251
Fax Number	:	813-814-9261

Provider Business Practice Location Address
First Line	:	309 STATE STREET EAST
Second Line	:	SUITE 201
City	:	OLDSMAR
State	:	FL
Zip	:	34677
Country	:	US
Telephone Number	:	813-814-9251
Fax Number	:	813-814-9261

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	02/09/2021

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Directions to “ JOHN H SHIM MD” Practice Location

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