Healthcare Provider Details

I. General information

NPI: 1689652661
Provider Name (Legal Business Name): SHIH-FONG HSU MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3425 S CLARKSON ST
ENGLEWOOD CO
80113-2811
US

IV. Provider business mailing address

3425 S CLARKSON ST
ENGLEWOOD CO
80113-2811
US

V. Phone/Fax

Practice location:
  • Phone: 303-789-8220
  • Fax: 303-789-8470
Mailing address:
  • Phone: 303-789-8220
  • Fax: 303-789-8470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number22593
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: