Healthcare Provider Details

I. General information

NPI: 1275722944
Provider Name (Legal Business Name): LING T SHIH MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2007
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4007 ORCHARD DR STE 2005
MIDLAND MI
48640-6187
US

IV. Provider business mailing address

4007 ORCHARD DR STE 2005
MIDLAND MI
48640-6102
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: LING T SHIH
Title or Position: PRESIDENT
Credential: MD
Phone: 989-631-6125