Healthcare Provider Details

I. General information

NPI: 1326570441
Provider Name (Legal Business Name): SEN SHENG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/29/2017
Last Update Date: 11/25/2022
Certification Date: 11/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 E. APPLEBY RD STE 402
FAYETTEVILLE AR
72703
US

IV. Provider business mailing address

P.O. BOX 550
LOWELL AR
72745
US

V. Phone/Fax

Practice location:
  • Phone: 412-647-7651
  • Fax: 412-644-2302
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberE-13979
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: