Healthcare Provider Details

I. General information

NPI: 1790780849
Provider Name (Legal Business Name): SHANG Y. RHEE, M.D. AND ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 02/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 MONROE ST BLDG A
SYLVANIA OH
43560-2263
US

IV. Provider business mailing address

5800 MONROE ST BLDG A
SYLVANIA OH
43560-2263
US

V. Phone/Fax

Practice location:
  • Phone: 419-885-8449
  • Fax: 419-882-7621
Mailing address:
  • Phone: 419-885-8449
  • Fax: 419-882-7621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number483559
License Number StateOH

VIII. Authorized Official

Name: TIMOTHY HALL SIGMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 419-885-8449