MEDICARE: DUEN SHIH 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	207L00000X	Anesthesiology Physician	25MA03107100	NJ

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	:	1629055637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DUEN SHIH MD

Provider Business Mailing Address
First Line	:	75 KEAN RD
Second Line	:
City	:	SHORT HILLS
State	:	NJ
Zip	:	07078-1409
Country	:	US
Telephone Number	:	973-564-8159
Fax Number	:	973-453-3308

Provider Business Practice Location Address
First Line	:	600 PAVONIA AVE
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07306-2929
Country	:	US
Telephone Number	:	973-564-8159
Fax Number	:	973-453-3308

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

Provider Enumeration Date	:	12/30/2005
Last Update Date	:	10/22/2013

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Directions to “ DUEN SHIH MD” Practice Location

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