Healthcare Provider Details

I. General information

NPI: 1669890075
Provider Name (Legal Business Name): HENRY HERCHUNG SHIAU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 07/08/2021
Certification Date: 07/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 7TH AVE S
BIRMINGHAM AL
35233-1711
US

IV. Provider business mailing address

1600 7TH AVE S FL 5
BIRMINGHAM AL
35233-1711
US

V. Phone/Fax

Practice location:
  • Phone: 205-638-9918
  • Fax:
Mailing address:
  • Phone: 205-638-9100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR1877
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD.42798
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberR1877
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code2080T0004X
TaxonomyPediatric Transplant Hepatology Physician
License NumberMD.42798
License Number StateAL
# 5
Primary TaxonomyY
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberMD.42798
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: