Healthcare Provider Details

I. General information

NPI: 1760919062
Provider Name (Legal Business Name): HYUN W SHIM DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2017
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2108 HARRISBURG PIKE STE 329
LANCASTER PA
17601-2644
US

IV. Provider business mailing address

2108 HARRISBURG PIKE STE 329
LANCASTER PA
17601-2644
US

V. Phone/Fax

Practice location:
  • Phone: 610-857-6201
  • Fax: 610-857-6202
Mailing address:
  • Phone: 610-857-6201
  • Fax: 610-857-6202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberSC006854
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: