Healthcare Provider Details

I. General information

NPI: 1275522294
Provider Name (Legal Business Name): LING T SHIH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4007 ORCHARD DR STE 2005
MIDLAND MI
48640-6113
US

IV. Provider business mailing address

4007 ORCHARD DR STE 2005
MIDLAND MI
48640-6113
US

V. Phone/Fax

Practice location:
  • Phone: 989-631-6125
  • Fax:
Mailing address:
  • Phone: 989-631-6125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberLS031767
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: