Healthcare Provider Details

I. General information

NPI: 1033140785
Provider Name (Legal Business Name): SHIXI CHEN OMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4610 SAWMILL RD
COLUMBUS OH
43220-2247
US

IV. Provider business mailing address

4610 SAWMILL RD
COLUMBUS OH
43220-2247
US

V. Phone/Fax

Practice location:
  • Phone: 614-538-0983
  • Fax: 614-538-0989
Mailing address:
  • Phone: 614-538-0983
  • Fax: 614-538-0989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number65. 000004
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: