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NPI Code Detail

MEDICARE: DR. CARL K. SHIN M.D.

MEDICARE: DR. CARL K. SHIN M.D.
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
1207W00000XOphthalmology Physician35043576OH

Other Identifiers

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

General Provider Information

NPI Number : 1326046251
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARL K. SHIN M.D.
Provider Business Mailing Address
First Line : 2141 MENTOR AVE
Second Line :
City : PAINESVILLE
State : OH
Zip : 44077-1323
Country : US
Telephone Number : 440-354-6900
Fax Number : 440-354-6400
Provider Business Practice Location Address
First Line : 2141 MENTOR AVE
Second Line :
City : PAINESVILLE
State : OH
Zip : 44077-1323
Country : US
Telephone Number : 440-354-6900
Fax Number : 440-354-6400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2005
Last Update Date : 05/06/2010

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