Healthcare Provider Details

I. General information

NPI: 1245020007
Provider Name (Legal Business Name): CONGZHOU SHA PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CONGZHOU MIKE SHA PHD

II. Dates (important events)

Enumeration Date: 05/07/2025
Last Update Date: 03/29/2026
Certification Date: 03/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

595 W STATE ST
DOYLESTOWN PA
18901-2554
US

IV. Provider business mailing address

595 W STATE ST
DOYLESTOWN PA
18901-2597
US

V. Phone/Fax

Practice location:
  • Phone: 215-345-2200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: