Healthcare Provider Details

I. General information

NPI: 1174504294
Provider Name (Legal Business Name): SHENG TCHOU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/07/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 PRINCETON RD SUITE 101
JOHNSON CITY TN
37601-2049
US

IV. Provider business mailing address

411 PRINCETON RD. SUITE 101
JOHNSON CITY TN
37601-2049
US

V. Phone/Fax

Practice location:
  • Phone: 423-979-2210
  • Fax: 423-979-2213
Mailing address:
  • Phone: 423-979-2210
  • Fax: 423-979-2213

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number023963
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: